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i <br /> ELECT CAL PERMIT APP ICATION <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 ADDRESS <br /> KLT-L A) Wj�/h Z llD �{o�f i1 �"y t'L� r ( <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 /> r-6 EL0L,�/S-3(,:9 <br /> State License Number(required) City of Everett Business License Number(required) <br /> .� ";C- ,__ <br /> Proposed Use of Building / Contract Price/of Work <br /> IK4rlfCCCIU (�ln��7- <br /> 2D��l <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: w sA-(.._ CfRCv i r <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 /DDD <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 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 /> performance of construction. That I am authorized by the owner of this property to perform the t (6 O j — (?, 4 <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 27 �� <br /> Signature Date <br /> REVISED O&Vd'2Of4 <br />