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� �o•3 �o <br /> ELECTRICAL PERMIT APPL�CATION <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 /> �11�i2�"iT�PS � �Y���r`rVl/�4•GoY <br /> . �; 5 /� <br /> PROJECT ADDRESS <br /> -�-'��'T �o�x 3�07 ��a��, �v�l 9�/2�2zo7 -���� ����z�2 � � <br /> Owner Mail Address City StatelZip Phone <br /> u. <br /> Tenant Mail Address City State/Zip Phone <br /> �t ���7"�a.r➢�i.�t. �,�x�l 7�t����� ,9�z75 �2�z9�/�95�� <br /> Electrical Contractor Maii Address City State/Zip Phone <br /> ���/��ecc 9S-�c�z o�a59� <br /> State License Number(required) City of Everett Business License Number(required) <br /> /$��aOe <br /> Proposed Use of 8uilding Contract Price of Work <br /> �i�"�'i►�i3iY1/Y1F�� ��GviT. G'� <br /> Square Footage(If residential new construction,remodel or addition) Contact PersonlContact Number/Emaif <br /> Number of devices(If low voltage) <br /> � , , <br /> , . <br /> Description of Work to Se Done: _��i��%GGf��� � ..E�N L����2� <br /> FEE <br /> CITY OF EVEhETT LOCAL SALES 7AX CODE IS 3105 ��DQ �� <br /> U <br /> I hereby certify thaf i have read and examined this applicafion and know the same to be true and <br /> correct. All provisions of laws and ordinances governing this type of work wi/l be compieted <br /> whether specifred herein or not. The granting of a permif does not presume fo give authority to PERMIT# <br /> violate or cancet the provisions of any otherstate orlocallaw regulating consfruction or the � � ��, t ���� <br /> performance of construction. That l am authorized by the owner of this property to pertorm the �,1 <br /> work for which application is made and 1 compiy with the SPate Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> ; -�/� �~l�v i <br /> gnature Date <br /> ��L� /Y��Q�/Il� GENERAL CONSTRUCTION COMPANY <br /> REV(SED 08/OG?074 �� � � P.O.BOX 46-MUICILTEO,WA 98275 <br /> �/n�' � 425 294-6944-FAX-425-294-6947 <br />