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7: . <br />' T- <br />/�5 /8j4.3 <br />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 />1E1/ERGTrEPS ® EVC-kET7W4- GoV' <br />o -zzl Jt �i. .T�Iz7 <br />PROJECT ADDRESS <br />�0,9 ,Box 3aZ &off wh' <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip Phone <br />Electrical Contractor Mail Address City State/Zip Phone <br />9"r- we-k�c 9 8 oz <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />oho <br />City of Everett Business License Number (required) <br />0l g4' Doa <br />Contract Price of Work <br />1A1 kj".1f <br />Contact Person/Contact NumberlEmail <br />Number of devices (If low voltage) <br />Description of Work to Be Done: <br />D FW JJ �® <br />CITY OF EVERETT LOCAL SALES TAX CO EIS 31 06 /n <br />1 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 taw regulating construction or the®�� �� <br />performance of construction. That I 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 />-/0- <br />gnature f f Date —_ _ .. <br />GENERAL CONSTRUCTION COMPANY <br />A 11 P. O• BOX 46 - MUKILTEO, WA 98275 <br />REVISED OB/Ofi2074 <br />�'A%/9�L L�, %� 425 294-6944 - FAX - 425 2%-6947 <br />