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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 /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> l/ Vy� <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number Contract Price of Work <br /> Proposed Ne oT Building Contact Person (Plan Review) <br /> � Z0 Tb <br /> Square Footage(If resi ential new construction, remodel or addition) <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: �r C e le e+Y i-cq( <br /> . 1 <br /> a wa Be Y)Lz 3 C I rC tit <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 7 C 00 <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 theI — <br /> performance of construction. That I am authorized by the owner of this property to perform the ` L� <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 153 <br /> 296.200 WAC. <br /> Signal re Date <br /> REVISED 3/20/13 <br />