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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 />IEF%/ RP_errEP5 ® EAVC-R&F'rrwo4- GO <br />— � � -, � �`l 6 Y4 <br />PROJECT ADDRESS <br />1-2207 -"1'25 3-1'2.2/z ! <br />Owner Mall Address city State/Zip Phone <br />Tenant Mall Address city State/Zip Phone <br />Electrical Contractor Mall Address City State2lp Phone <br />9 8 c7Z <br />State License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (if low voltage) <br />Description of Work to Be Done: <br />City of Everett Business License Number (required) <br />/T mv,:-) <br />Contract Price of Work <br />li�tRl, Hoi/w r; e6 ,�7/' 0iT c� <br />Contact Person/Contact Number/Email <br />7. <br />-FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />1 hereby certify that 1 have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming 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 / am authorized by the owner of this property to perform the E <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC_ <br />GENERAL CONSTRUCTION COMPANY <br />REVISED 08MM014 A ll P. O. BOX 46-MUKILTEO, WA 98275 <br />425-294-6944 - FAX -425-294-6947 <br />