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�'= ., _ Z�'.� <br /> -� ELECTRiCAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVlCES � <br /> 32Q0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - �FAX 425-257-$857—www.everettwa.org <br /> �1(E12��7T�PS � C�ER�'7'rvl/�•�GoV� <br /> �a�� ���..� ���.v � �z <br /> PROJECT ADDRESS . <br /> ��/�'Y �'D BoX 3707 w�I 9�/2�2Zo7 ��� 3�Z•2/z/ <br /> Owner Mail Address- City State/Zip Phone <br /> :::.:�., - <br /> :r. <br /> Tenant Mall Address City State2lp Phone <br /> ��� 1����i,���.�X. �,�X�Sl�7�� �h �f�Z75 -�2��9��95�� <br /> Etectrical Contractor Mall Address Ciiy State2ip Phone <br /> ���/E�e�c 9 8-�c�z_ o�DS 9� <br /> State License Number(required) . City of Everett Business License Number(required) <br /> � � 98 voa <br /> Proposed Use of Building Contract Price of Work <br /> 1��Ri�f��tmrn�e� �E�viT c� <br /> . . Square Footage(If resldentiai new construction,remodel or addition) Contact Person/Contact Number/Email <br /> �t� Number of devices(If low voltage) <br /> .�. - <br /> .•� Description of Work to Be Done: �����"�. �d'� ���`''���1� S ��/.��� <br /> � . <br /> � . . FEE,, O <br /> ��,/3 5' � . <br /> ClTY OF EVEhETT LOCAL SALES TAX CODE IS 3105 � <br /> I hereby certify that I have read and examined fhis application and know the same to be true and <br /> correct. A!l provisions of taws and ordinances governing this type of work wiil be completed <br /> whefher speciBed herein or not. The granfing of a permit does not presume to give authority to PERMIT# <br /> violate or cance!the provisions of any other stafe orlocal law regulating construction or the C ���� _ ��� <br /> pertormance of construction, That 1 am authorized by the owner of fhis property to perform the L <br /> work for which applicafion is made and I comp/y wlfn the State Confractors Law 18,27 RCW and <br /> _ 296.200 WAC.., <br /> � , <br /> � r <br /> + gnature Date --••------ _ � - -----_..._- -- � ------• --—`I <br /> GENERAL CONS'TRUCTION COMPANY I <br /> REVISED 0&ON2014 P.O.90X 46-MiJKIL.TEO,WA 98275 � <br /> 425-294-6944-FAX-425 294-6947 <br />