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• i <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 ADDRES <br /> Owner Mai 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 /> SquareSquare Footage (If residential new construction, remodel or addition) Contact Per /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 15, <br /> I hereby certify that I have read and examined this application and know the same to be true and <br /> correct. All provisions of E <br /> s and ances governing this type of work will be completed <br /> whethe ecified herein The gra 'ng of a permit does not presume to give authority to PERMIT# <br /> viola or ancel the pr ns of any oth r state or local law regulating construction or the ,_ b ��� <br /> perf rma ce of constr ction. That I am thorized by the owner of this property to perform the I,J, <br /> wo k for hi( <br /> applica 'on is made an comply with the actors Law 18.27 RCW and <br /> 296.2 WAC. <br /> Signature Date <br /> REVISED 08/06/2014 <br />