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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERF rT, WA 98201 <br />425-257.8810 - FAX 425-257.8857 - www everettwa orq <br />3VO Pew't4f AVP- <br />PROJECT ADDRESS <br />H11fzK (Os( trALfIOA 't""Vuaks Wo <br />Owner <br />Vad Ad lrex <br />t <br />t,l+y poll't (cs ur <br />31ao � <br />Tenant <br />'Aaa r•,drev. <br />���t1 <br />Sys-tery <br />a`1oo Har <br />Elecin <br />I Con raclo' <br />Mad r o:ress <br />&CF, yN c Mr. L.3 <br />Slate License Number (required) <br />Proposed Use of Budding <br />Square Footage (II residential new construction, remodel or addd*n) <br />Number of devices (II low voltage) <br />Description of Work to Be Done <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />fuen*I kA VA, 1 � <br />City Stmeizrp <br />uere WA <br />1 ."'. <br />Cay sixi Phone J <br />r-dv <br />+ere++ wA 45r'ao-? (rf�sjI-K,)l2r <br />stal.2ro <br />i true <br />nay 7 34 <br />City of Evi gu;mess License Number Irn_ouned) <br />/0n <br />Contract Price of Won <br />1 <br />I hereby certify that I have read and eramrn9d this aoplrcahon and know the *ame to be true and <br />correct All provisions of laws and ordinances governing this type of work wfif be completed <br />whether specified herein or not The granting of a permit does not presume to give aufho"ty to <br />violate or cancel the provisions of any other state a local law regulating ednsirrclron or fhn <br />performance of construction That lam ardhonted by the owner of fhis progeny to perform the <br />-rork for which application is made and I comply with the State Contractors Law lq 27 RCW and <br />296 200 WAG <br />REviscoosow" <br />Frr <br />tiTr — <br />�/ll_ <br />