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�L C R���L � � I� � L�CA�ION <br /> CITV OF E�/ERETT PERIOIIIIT �ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> 7�� , <br /> �� (�/-� S � j� � ��,�.v�-ir� <br /> PROJECT ADDRESS <br /> S'��- ,� (� �� / �s �,� �� <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> CI' (i✓ j/L�-�/"' <br /> EleCt�ical ContfaCto� Mail Address City State/Zip Phone <br /> State License Number(required) City of Everett Business License Number(required) <br /> I"��� �'�/` 2 v� � <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: ' ' � � 1 L G <br /> Q - �f� —ii �'<G e— l��' 'L� <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAX CODE 1S 3105 � l�� ��� <br /> I hereby certify that I have read and examined this application and know the same fo 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 PERMTT# <br /> violate o�cancel the p�ovisions of any other state orlocal law regulating construction or fhe <br /> performance of construction. That I am authorized by the owner of this property to perform the E I� ��,� I�� <br /> work for which applic � is made and I comply with the State Contractors Law 18.27 RCW and <br /> 296.200 AC. <br /> � � � <br /> i ature Date <br /> REVISED 08/O6/2014 <br />