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irk - /7Sj- min / <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 /> i <br /> PROJECT ADDRESS <br /> ���� LD7Ba -37197 L LCG✓ <br /> 3ZI22/2 <br /> Owner Mall Address city State1Zip Phone <br /> Tenant Mail Address City State/ZIP Phone <br /> 316 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> s-�/oz <br /> State License Number(required) City of EYerett Business License Number(required) <br /> 5;at� <br /> Proposed Use of Building Contract Price of Work <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 /> i <br /> CITY'OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I 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/am authorized by the owner of this property to perform the <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 295.200 WAC., <br /> . vC <br /> gnature Ar Date --------- - - - ---------- - -- -__.... _...—, <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED OBro62o 14 P.O.BOX 46-MUIQLTEO,WA 98275 <br /> 425-294-6944-FAX-425-294-6947 <br />