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ELECTIOCAL PERMIT APO%CATION <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 /> rye-c-+l r , <br /> PROJECT ADDRESS (� <br /> OVA 4, <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> V�CAttu �:� �' B,"< lam <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> VE C'-j 5 Li 2 Ntu <br /> State License Number(required) City of Everett Business License Number(required) <br /> 2C `�-- <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: --xk,,-iJ (!C s1 U ✓lam:'!C Ll.11: 14 <br /> � P I' jj <br /> .�,T f��� ` Li �l�j� Ai[,vi <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �O <br /> e � <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 goveming 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 E O 09j& <br /> work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Si ature D afe <br /> REW SED 08/06/2014 <br />