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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 />PROJECT ADDRESS <br />/� �/Jj �7 L, / -/7 <br />282E ELT PU 4B X -3 707 �� �4 / V /Z / Z ZD / �L ✓ / z� z/� <br />Owner Mail Address City Slate/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />9 $--�az 0-�05 9'9 <br />State License Number (required) City of Everett Business License Number (required) <br />�7 <br />Proposed Use of Building Contract Price of Work <br />l � 4w)- IyIl ozeie T, co <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 />/ <br />I hereby certify that I 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 />of construction. That I am authorized by the owner of this property to perform the E'��' <br />performance <br />work for which aDDlication is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />Ij <br />gnature i Date <br />GENERAL CONSTRUCTION COMPANY <br />P. O. BOX 46 - MUKILTEO, WA 98275 <br />REVISED 0"612014 �� 425-294-6944 - FAX - 425-294-6947 <br />