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To: E Page 1 of 8 2016-01-19 21:59:52(GMT) 18884000383 From: Deborah Shields <br /> ELECTRICAL PERMIT APPLICATION <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5028 DOVER ST <br /> PROJECT ADDRESS <br /> KELLEY SMITH 5028 DOVER ST Everett WA 98203 425-931-2951 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Washington Energy Services 3909 196th St SW LYNNWOOD WA 98038 800-398-4663 <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> WASHIES854NG exp 09/07/17 $400 <br /> State License Number Contract Price of Work <br /> SFR <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: <br /> Add/alter 1 circuit for gas fireplace insert. <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certify that l have read and examined this application and know the same to be true and V f „©� I�( <br /> correct. All provisions of laws and ordinances governing this type of work will be completed v �/ I <br /> whether specified herein or not. The granting of a permit does notresume to give authority to <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 <br /> work for which application is made and/comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> ".01 „v,,,e +` Digitall},signed by Jennifer Cov ilo <br /> DN:cn=Jen nilerCovello,o,ou,.email=;enn;fer@nwpermitcorn, <br /> ? ' >,'I n'intSignu <br /> 3.'S:L•Oi_::i1L�ClCS' <br /> Date <br />