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Dec. 20, 2015 1 ; 29PM General Construction Company No. 6101 P, , � V5 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - rAX 425-257-8857 —www_evereftwa.org <br /> Z// _�� <br /> PROJECT AbbpEsS <br /> i� �o SoX 3�a7 ���� /-�� 9 8/z�/z X07 �z5 .3�z•z�z <br /> Owner Mail Address CRY State/Zip Pliune <br /> r <br /> Tenant Mall Address city S131021p Phone <br /> Electrical Contracfor Mail Address City SialeiZlp Phone <br /> �Fil/EieGG' 9 5 07_ 0-1705 2!2 <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage(If rosidential new construction,remodel or addlllon) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done; <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that 1 have read and examined this application and know the same to be true and o��1 <br /> correcl_ All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not presume to give authority to PERMIT# <br /> violate or cancel the provisions of any other state or local low regulating construction or the 512 r <br /> performance of construction. That 1 am authorized by the owner of this property to perform the I1Yn <br /> work for which application/s made and/comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> gnalure Dale <br /> GENERAL CONSTRUCTION COMPANY <br /> -,t, P.O,-BOX 46-IYWKILTEO,W A 98215 <br /> RFVI$FO Ofl/Off20 r 4 GffJJ 425-294-6944-PAX-425-294-6947 <br />