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9 9 <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.gov <br /> PROJECT ADDR 1 S `FSS• A 1 ' S�(A <br /> L-,544 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip <br /> A flm 1101�d ebA4-Tl� P�F'tvlk �JA- 1270 <br /> ElecHcll 'Contractor Mail Addr ss City j 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: <br /> FEE � ) <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 d� t/ " <br /> l <br /> I 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 I ` ��, <br /> performance of construction. That/am authorized by the owner of this property to perform the '-1�1' <br /> work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAG; <br /> t = � <br /> Signature Date <br /> �J <br /> REVISED 08/06/2014 <br />