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. 9/o,4°.°/ �a > <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 /> EN( /aE TEP5 a /Eke rrWAt.-GOV. <br /> - .35 6/ rry-// <br /> PROJECT ADDRESS • <br /> . / - l' i0.BOX 3 7o7 a Sxa IVh' 9F/22/2207 i25 .312.2/21 <br /> Owner Mall Address- City State/Zip Phone <br /> • <br /> Tenant Mail Address City State/Zip Phone <br /> .O <br /> 9. i .. ' ,evx4/l )_r .e)%) 19,275 -1?/25-29g# <br /> / <br /> Electrical Contractor Mall Address City State/Zip Phone <br /> 4-EA/5Rec. 9 s- oz. 0 05.9 <br /> State License Number(required) . City of Everett Business License Number(required) <br /> 70, 000 <br /> Proposed Use of Building Contract Price of Work <br /> . ri/tinwea ,��'vi <br /> Mki7. cert <br /> • Square Footage(if residential new construction,remodel or addition) Contact Person/Contact Number/Email <br /> .i Number of devices(If low voltage) <br /> . <br /> Description of Work to Be Done: ,%/ / / // �_1/i%/���>IP / %�1% ._ u�%F 4 4 <br /> . - bit/4&}/21 _/ /f illi� /�� �0,_ <br /> c . <br /> ' <br /> • <br /> FEE„ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 Ty/�j/a D� <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 E ' �t� <br /> performance of construction. That I am authorized by the owner of this properly 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 /> /-10 /7 <br /> . gnature Date <br /> GENERAL CONSTRUCTION COMPANY <br /> REVISED 0&D62014 P.O.BOX 46-MUKILTEO,WA 98275 _ - <br /> 425-294-6944-FAX-425-294.6947 <br />