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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 /> evgFke T�Ps 0 evek TWAf.�GOV. <br /> 5 M /AS <br /> haw- <br /> PROJECT ADDRESS <br /> jO0 Sok -37o7 &1� lz)4 '991241-2207 3212-212 / <br /> Owner Mall Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State2ip Phone <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 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 /> 1 hereby certify that f 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 �O y <br /> performance of construction. That/am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> 1 ✓ <br /> gnature Date — ----- - ------ <br /> GENERAL <br /> ----GENERAL CONSTRUCTION COMPANY <br /> REVISED 08A762074 P.O.BOX 46-MLTF:ILTEO,WA 98275 <br /> 425-294-6944-FAX-425-2946947 <br />