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__�- `� <br /> � • AL PERMIT APPLICATION <br /> �, ELEC�RIC <br /> 'I CITY OF EVERETT PERMIT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> I 425-257-8810 - FAX 425-257-8857 -wwv+ evereUwa org <br /> � I <br /> I 70� z c, — � <br /> � PROJECT ADDRESS I <br /> I . _ .. ____. -___._.—_. CIy _ .'__._." SIatNZ�p —__—__Phone <br /> � Ovmer If�a�lAdr,�e55 <br /> //� //,� p � /�d llQ I!i ���—�✓.Qs� L�.��^-�------—' <br /> .L..����_1---. � �� Sla!C�7�P Phone , <br /> Tcrarl IlaJ Addiess �� <br /> ��C�" �� � [ J sr.SC EuQ.Gf�_ C'✓�}- QlY�� �/1S�s S�y� <br /> ��N _ �(X-e-(i--G .z0/l j Slate�Zip P�o�e <br /> ' - �daii Aad�ess �`Y <br /> F iectncal CoNracto� <br /> fG �rr G,Z.tl�I _. G''���_ -- I <br /> � Slate License Numher �requu=d) Qty ol Fveretl Business License Number(requrted) I <br /> 700 - <br /> � l� �° Conlract Pnce ol Woik � <br /> . Vroposed Use of Budding �I <br /> ' Con!ac! Person!Contacl NumbcriEmad � I <br /> ' Square Footage(If residen:�al new corstr�ct�on remoJel or addihon) i <br /> � Number of dev�ces QI low voltagel <br /> � Descnphon ol Wo�k to Ne Donc _f���� _��-- --- � -" �� <br /> I - - — <br /> � ---- E_ ..-- --- --� . <br /> , �_ �0�,� <br /> i GTY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br /> --- ___ <br /> 1 hereby cerlAy Ihaf 1 h.ive rcad and erammcA Ihis applir.ahnn arrd knrnv Ihe sarne (u hr f�uc ,+ru - ___ -_---- -- <br /> ' cnnecf All prov.srons o/lu�vs and ordmances gnvem�ng fhis typo ol morA �sdl be crnnplefed �cRMll # <br /> I whetNer specrhed ��P��rr o�nof 1he gran(rriy o!a pennd docs rro!presume fo cj�ve nufhnnly fo I � I � O� - ��� <br /> v�o�ate nr cnncel fhe provis�ons o/any ofhe�state o�iocal law mgulahng cunshucGon or�he <br /> � perfonnanr.e of consl�uclion Thal l arn authonreA hy fhe o�vner o/Ihis pmperty fo pe�fonn fhe I - . <br /> �vork lor which app6cnfron rs maAr, and 1 r,omply�vdh fhe Sfalc Contradnrs La�v 18 27 HCN'.�nd L <br /> I 296 2G0 W�C <br /> II � � ---- <br /> ��� �?'—/Y-x-r.� <br /> Signaiur <br /> — Date <br /> n�r:F"ocsn6?nu . ____ . '__ . . ._ . _ <br />