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y 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 /> k1/eFP_iT'gPS a evek1✓TTW'p '-Gov- <br /> PROJECT ADDRESS <br /> '9Y12--1' -2207 3z12-212 / <br /> Owner Mall Address city Stale/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> &x�lv 7i�,��/ <br /> Electrical Contractor Mail Address City % tate/Zip Phone <br /> State License Number(required) City of Everett License Number(required) <br /> Proposed Use of Building Contract Price 6f 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 1S 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of74ws 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 l ` V <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC., <br /> /a- <br /> gnature <br /> Date ------- - _ ...- - - -- ----- - ---, <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED Od10 2014 F.O.BOX 46-MUKILTEO,WA 96275 <br /> 425-294-6944-FAX-425-294-6947 <br />