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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 ADDRE S <br /> v� "57 q2g <br /> � <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zi Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State icense Number(required) City of Ev tt Business icense Number(required) <br /> 12—0 <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: <br /> FEE <br /> CITY OF EVERETT•COCAL SALES TAX CODE IS 3105 <br /> J <br /> 1 hereby ce ify,that I.Yiave read and examined this application and know the same to be true and <br /> correct. AI �ovisions of laws and ordinances governing this type of work will be completed <br /> whether s ihed"herein or not. The granting of a permit does n t presume to give authority to PERMIT# <br /> violate or noel the provisions of any other state or local law re ula Ing construction or the <br /> perfonnabf construction. That 1 am authorized by the owne of his property to perform the <br /> work for}v ch application is made and I comply with the State Con actors Law 18.27 RCW and <br /> 296.2M C. <br /> / ig ature ( aft <br /> REVISED 08/06/2014 <br />