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11 �` 24f 2014 10: 00 2063292228 <br />� <br />Sty1E1 PURCHASING <br />� <br />EL�CTRICAL �ERMIT APPLICATIQN <br />C�TY O� EVERETT P�RMNT �ERVICES <br />3200 CEDAR STR�ET, EVER�TT, WA 98201 <br />425-257-8810 - FAX 425�257-8857 — www.�verettwa.org <br />22� Z — Ut <br />PROJEC'T ADDR�SS <br />PaGE 01 <br />�- C� �=-- �'C' r2-� t <br />Owner Mall Address Ciry State/Zip Pnone <br />�. '�' <br />G�. �- '" Vt� �2 �"C7 ��fz <br />Tenant Mall Addreas City Siate/Zip Phone <br />� <br />EIeCt�iCa! Contractor Mail Adtlres6 <br />i�-.c1�5�'I�t�1� <br />State License NUmber(requir�d) <br />Froposed Use of Building <br />��, S, s e�-���� �� <br />Square Footage (Ef residential new construction, remodel or additian) <br />� <br />Number cf devices (lf low vo(tage) <br />%ity <br />Statefz�p <br />�a�- �57-og <br />�e��wy <br />Phane <br />o� 3 522. <br />Cit�f EweretY Business Licen$e Number (required) <br />, �-� <br />Contra�t Price OF Wofk <br />�'�� k,ov��Kr.S Zr� I� 3� / -�, ��'� <br />Contact Person/ContaC't Numberl�mail <br />� e.ti +— ��A�C,1 F I c� F� � t c� <br />5�a p »�. G� v►'L <br />Descrlption of Wark to Be Done: �..QN1�fCZ� ( N� N S�2t� UK,�� �6 y�.�� <br />1 �� � ���� � S t✓� . <br />C,O T�3��C`T" S� N► � d�P ��R � �� r4.��OV� ��� <br />��TY aF EVERETT �OCAL SALES TqX CODE I��� Y� F J `" �� i ��� <br />��5� <br />I her�by certify thaf ! heve read and examined this applicatian and know the same fo be true �nd � <br />corr�ct. All provrsr'ons of laws and ordinances governing Chrs type of worec wil/ be com�vleted <br />wHether speciFed herein or not. The granting of a perm!! does not presume to grva authorify to <br />vlolate or esnce/ the provisians of any other staie or /ocal !aw regulatrng construction or the <br />performance of constrvction. Thai 1 am authorized .by the owner of this property to perform the <br />work for which ap Ncstron is made and ! comply w;fh fhe Sfafe Contractors Law 18 7 RCW and <br />296.200 WA <br />! L � T % � <br />REVI SED <br />PERMzi'# <br />�i y I I - �Z�� <br />