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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www,everettwa.org <br /> PROJECT ADDRESS <br /> L/�T Po.OX 37197 �'� wh' '9 42207 -1`z5. 3212-2/2 I <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> ��N�R2c 9 S- oz 0-�05 949 <br /> State License Number(required) City of Everett Business License Number(required) <br /> L <br /> Proposed Use of Building Contract Price of Work <br /> );�k/".//6mvn�ea 0� 'T c� <br /> Square Footage(if residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> Description of Work to Be Done: <br /> FE' E �f 3(a 3D•�d <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that/have read and examined this application and know the same to be true and <br /> correct. 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 law regulating construction or the n <br /> performance of construction. That I am authorized by the owner of this property to perform the E <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and / <br /> 296.200 WAC., <br /> gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> P.O.BOX 46-MUTULTEO,WA 98275 <br /> REVISED 061062014 <br /> LC ,� 425-294-6944-FAX-425-294-6947 <br />