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` ��ijlDi✓ <br /> . U�tD7 j-1 <br /> 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 /> 1EVE21✓'�f'rG PS ® 01Eke-M-WAr-GOV <br /> �k <br /> l� <br /> PROJECT ADDRESS <br /> -/ic� iOo BoX -37o7 aS� -� �� g�/2�Z Zo7 --1'26 35��-z/z l <br /> Owner Mail Address City Stale/Zip Phone <br /> v. <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number (required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Aki. HrIMIMEea <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 /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that 1 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 <br /> performance of construction. That i am authorized by the owner of this property to perform the E ` �-a O <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> - l <br /> gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> M P.O.BOX 46-MUKILTEO,WA 98275 <br /> REVISED OM62014 �//� ' 425-294-6944-FAX-425-294-6947 <br />