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0 • <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 /> PROJECT ADDRESS <br /> Owner Mail Address City State/Zip Phone <br /> a bc ) ()I Cp 62c -�yy-370' <br /> Tenant Mail Address City State/Zip Phone <br /> C�Y L I ecrk3-Cc& SvQ P t� Sc( QI is S 26 11 S 9 At PL- VcW1 & -r.X)- c1�0 31 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> LWWuf(�dJ Qfc)(-ev- -# I s:f, cuo <br /> Proposed Use of Building Contract Price of Work <br /> Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices (If low voltage) <br /> Description of Work to Be Done: �uyt'O kk1��\vw1 t t, Ca<��f 5 arcwy\ D u c4 e-S C&AC — <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that l have read and examined this application and know the same to be true and ` V <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 <br /> performance of construction. That I am authorized by the owner of this property to perform the E [,5( 0-095 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. / <br /> V _ <br /> `7 e Date <br /> REVISED, <br />