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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.gov <br /> 3 5 0 i Cot- f YES ? T-C 'z- <br /> PROJECT <br /> PROJECT ADDRESS <br /> '2 g2q RticKF-�-Rvr �/o� ��6<E�'l" <br /> Ce-? CR-EAjW I C lPt 06 LLC- q 2s-33`1-3638 <br /> Owner Mail Address City State/Zip Phone <br /> A-1-10ME1 6F'V6,Z41C- 3501 C,Le j AVC- �RETi � 982ar y25-257- 2170 <br /> Tenant Mail Address City State/Zip Phone <br /> e-n(i nt - <br /> Electrical Contractor— Mail Address city State/Zip Phone <br /> Ug ( tat& ��� <br /> State License Number(required) City of Everett Business License Number(required) <br /> Proposed Use of Building Contract Price of Work <br /> Ml4RK fC0FWfr- 36v — 66Sf'ol72 <br /> M&&Ktt (i�- A-TG, W!}. 6O <br /> Square Footage(If residential new construction, remodel or addition) Contact Person/Contact Number/Email <br /> Number of devices(If low voltage) <br /> �(ENftN'� WALL <br /> Description of Work to Be Done: /}T-Tf�C H W t F SS GC Ss 10 CCr rte/ <br /> T,c. :5 11�N p ("t'l a6cr W I T' h mss ' CAT-6 ptr,c jt CALe -T0 5w -rTC 14 <br /> r.) PA 4 F C A-6 TO g Fks P EryD�p "o^^y E C E t c rn/G- i, ES .FEE 6'A t,t- 1°�- <br /> CiTY OF EVERETT LOCAL SALES TAX CODE IS 3105 PA 14m 6`-4< <br /> l hereby certify that/have read and examined this application and know the same to be true and 5�-' <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 PERMIT# <br /> violate or cancel the provisions of any other state or local law regulating construction or the <br /> performance of construction. That/am authorized by the owner of this property to perform the E) 5 Ore—J 47J <br /> work for which app!' ation is made and l comply with the State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> `- w/ / 7 - <br /> Signa#m — Date <br /> REVISED OBO 2014 <br />