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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 �jQ <br /> � �Off^ V1�/Ct�C7L- bb- <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address ? City / 1 State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phon <br /> State License Number(required) Ci y of Everett Business License Number(required) <br /> m ul-+i 0 <br /> Proposed Use of Building Contract Price of Work <br /> 40t � <br /> Square Footage(If residential new construction, remodel or addition) Ctht-P e�rs o n/C o�nta ct 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 /> I hereby certify that I have read and examined this application and know the same to be true and u <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 orlocal law regulating construction or the E t�o� J a�� <br /> performance of construction. That lam 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 /> 296.200 WAC. <br /> 'gnature Date <br /> REVISED 06106/2014 <br />