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t:�-.. _ n .. � a��� <br /> �.. <br /> .� <br /> � ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www,everetfwa.org <br /> �vEi2�'fiT'�Ps � ��RE�rrw�.C�ov <br /> � � / <br /> PROJECT ADDRESS <br /> ,����' �D.�OX 3707 a�'��� ��I 9S/Z�2207 �Z� e3`��•Z/Z / <br /> Owner Mail Address City State/Zip Phone <br /> •:..;�. <br /> :,r• <br /> Tenant Mail Address City State/Zip Phone <br /> ��1�,��/,�a�t�D�ia��i�t. �,�x�l��r4 9�Z75 �2��9���� <br /> Elecfrical Contractor Mail Address City State/Zip Phone <br /> ��N��ecc 9 S-�oz o�a5 99 <br /> State License Number(required) City of Everett Business License Number(required) <br /> 9. a�o <br /> Proposed Use of Building Contract Price of Work <br /> 1��t�ei.H�tn���e� k���T c� <br /> Square Footage(If residential new construction,remodel or addition) Contact Person/Contacf Number/Email <br /> ��� Number of devices(If Iow voltage) , <br /> .-. <br /> �: ' <br /> Description of Work to Be Done: . � <br /> • � <br /> _ �������� � <br /> FEE � �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 2,�� <br /> !hereby certify that 1 have read and examined thls application and know fhe same to be true and <br /> correct. All pravlsions oilaws and ordinances governing this type of work wil/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 fhe provisions of any ofher sfate or local lew regulating construction or the � ���r/ ` <br /> performance of consfruction. That I am authorized by tf�e owner of this property to perform the ""� <br /> work for which application is made and J comply wifh the State Contracfors Law 18.27 RCW and <br /> _. . <br /> 296.200 WAC.,, <br /> , .'. „ / . <br /> = ------- -- - --- -- ------. ---1 <br /> . gnature Date � •, <br /> ��L�� /r'(Gux/�(zG,�/C GENERAL CONSTRUCTION COMPANY � <br /> P.O.•BOX 46-MUKILTBO,WA 98275 ( <br /> REVfSED 0&bG?01q ' �^m � 425-294-6944-FAX-425 294-6947 ' <br />