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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />PROJECT ADDRESS <br />Owner Mail Address City State/Zip Phone <br />Tenant Mail Address City State/Zip LS Phone <br />Electric/al Contractor Mail Address City State/Zip Phone <br />State License Number (i equired) City of Everett Business License Number (required) <br />Irk- K. <br />Proposed Use of Building Contract Price of Work <br />Na <br />Square Footage (If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br />Number of devices (If low voltage) /� p den <br />Description of Work to Be Done: e L L l J `// 647 <br />FEE7_C 9 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <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 _uthonty to PERMrf# <br />violate or cancel the provisions of any other state or local law regulating construction or the C <br />performance of const ction. That I am authorized by the owner of this property to perform the E iSo I —D.1 z <br />work for which pi ation is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC /! <br />P <br />R1Signature Dat <br />1SEDOW62014 <br />