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Aft Adl� <br /> CITY OF EVERETT PERNT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 7DgO6 tr.�e-�W Aim <br /> PROJECT ADDRESS <br /> 3 o v.. Aj t-, a0lia�-c- ` `�'1 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <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: p <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> s <br /> l hereby certify that/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 �� <br /> erformance of construction. That /am authorized by the owner of this property to perform the L`J, <br /> for which application i de and l comply with the State Contractors Law 18.27 RCW and <br /> 96. 00 WAC. <br /> S <br /> ignature Date t <br /> REVISED 08/06/2014 <br />