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129 MADISON ST A 2016-08-30
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129 MADISON ST A 2016-08-30
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Last modified
1/12/2017 8:48:40 PM
Creation date
8/24/2016 8:25:32 AM
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Template:
Address Document
Street Name
MADISON ST
Street Number
129
Unit
A
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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 />; 2°C .M � I� I SO r�J � I <br />PROJECT ADDRESS <br />I:y�q �� ����' � �.,� I �� �,1 �DiSo�t.i �T -#A �✓�� �v �- � $ �2� - <br />Owner Mail Address City State/Zip Phone <br />Tenant <br />v � V�,' V �� <br />Electrical Contractor <br />State License Number <br />Proposed Use of Building <br />Mail Address <br />Mail Address <br />�1 ol�L L r'- �.�"') r-,C� �'tz <br />Square Footage (If residen ial new construction, remodel or addition) <br />Number of devices (If low voltage) <br />C ity <br />City <br />State/Zip <br />State/Zip <br />Contract Price of Work <br />Contact Person (Plan Review) <br />Description of Work to Be Done: �fl�} iN� J��f �z(L�ii. �L� 1�1-1� � �v i Z--� �-S l,(,�E��. <br />,4 M U ti � 1\,�' i_; 1"J 2;'� I� ��U Z,� <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 he completed <br />whether specified herein or not. The granting of a permit does not presume 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 applicafion is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. � <br />-- � o r <br />REVISED 3/20/13 <br />Phone <br />Phone <br />FEE <br />L-C� �� <br />PERMIT# <br />E 130� - C� ��� <br />
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