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1122 BROADWAY 2016-01-01 MF Import
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1122 BROADWAY 2016-01-01 MF Import
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Last modified
1/23/2017 6:56:08 PM
Creation date
1/23/2017 6:54:27 PM
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Template:
Address Document
Street Name
BROADWAY
Street Number
1122
Imported From Microfiche
Yes
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��. <br /> .r�. � . <br /> CITY OF EVERE7T �ATE: <br /> E1E„TRICAL WIRING PERMIT APPLICATION Fr: <br /> IlZZ <br /> .,'OB ADDRESS /�� ��J ��.���U <br /> TENANT <br /> PROP�rv owrFR �(f/q 7!D�tl Af. 1,uues�rn e n yL5 (�,�� <br /> ELECTRICAL COtJiRACTGR �Q �C — eC Tl�/ G <br /> ELEC. CONTRACTOR'S MAILING !!��JRES.: ��� 9 — / D �YC �. ER 5 T <br /> LICENSE N0. �A/C.FZ..Z�' �r)� EXFT_R?'i0N DATE <br /> ADMINiSTRAT(7i �/� ,(�'/2/� T/� pHONE N0. S3�— y3.S y <br /> VALU� OF WORK (Co not include taxes) <br /> (for commercia work <br /> USc OF BUILDI"JG / f /D %E�. <br /> NOTE: 'r1AC 296-46-140 reauires thst plans Por electrical work at educational, <br /> institutional or health care facilities be �pproveC by the State o` <br /> Washinaton. Applicants with sucn jobs �;,ust show the State-approved plans <br /> befure a City of Everett permit wili Ce ±ssued. <br /> 190RK TO BE D�i <br /> �mPo�2� 2 TDwEl� , <br /> ! C� <br /> i �_' <br /> SIGNED : _ •� —��_� _ DATE 8- � _ �C f+ <br /> NOTES AN� COWdENTS: <br />
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