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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 naafi Address City State/Zip Phone <br /> Tenant Mall Address City State/Zip Phone <br /> 9 Do <br /> EleOtncal Contractor Mail Address City StatelZip Phone <br /> State License Number(required) O <br /> ©� � � <br /> City of Everett Business License Number(required) <br /> S V- ag 3 od <br /> Proposed Use of Building Contract Price of Work <br /> -)OD Mks :�" <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: <br /> y � <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 6 <br /> !hereby certify that I have read and examined this application and knout the same to be free 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 loco/law regulating construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the E 03 I <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW end <br /> 9 ,200 WAC, <br /> Signature Date <br /> REWSED 08/06/2014 <br />