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I . _ . _ . " " -. .. . <br /> � I <br /> ELECTRICAL PERMIT APP�.ICATION ► <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www everettwa org � 2 - 10 - ��l <br /> r- f, iU �� -o3Y <br /> �c�c:%� 1,����� i�aS,rlo i'-lr�_cl �U�rrl�"�wia �j�,���c� � c� .�..��J� <br /> PROJECTADDRESS <br /> Yi�°F.x�,c��^c� "�cu i,ue`�� l'QS��';G �-'r,-,�l C�'2r'P 4t , v.� ia, �1n�G�/ - <br /> � OWner Mail Address Cty Slate�7�p P�onc <br /> , �� -� � 7C���'� L�l,'PSfi �� 1. �;C. '�Y� , ( � � C� �c <br /> �LL �� �5,�—_�—__ E�f�Ct �1 � ��1� <br /> Lf- --- - -�---- -1--- <br /> � lenant h1a�iAddress Cty StaierZ�O Phone <br /> '� � � � 'YY�YI�.S�4'� �_� �r'�L_iY]i_1a—1,Y N �n.1 , Ca�W �15Z'�'�'—_— — <br /> . Eletlncat Conlractor 61a�1 Address C�!y Slater7�p Pnone <br /> ! Nei h�c,�l_CuS�S L �-1c'���'1[!.� t_�i�l-���k'. �'' 7 ''G' ( - - <br /> State License Number�ieqwre 1 CAy of Everetl [3usmess License Number(reqwred) <br /> '� iV1L'�\,��C�\ �����-'------ -- — i <br /> Proposed Use ol6uilding Contract Pnce o1 Work � <br /> �=GiL���l1.� Il-'P�S�'•��l � <br /> ZC,�-�-�( -� -'��C,,i �7 t"� (-Scv�N' I <br /> �._ --- <br /> Square f�ootage�1i residenbal new conslruchon, remodel ni aAdilion) Contacl Peison�Contact NumbedEmail \-�����7P�15<> > <rti <br /> i I <br /> i Number ol devices �I�low volla9e) <br /> IDestnplion of Work lo Hc Done �;,° O � CV �( -_L;��_—��..?1 � L_— _--_--. .--- I <br /> --- -- --- ---- FEE— —' --- -- <br /> fff— /y ) I <br /> I CITY OF EVERETT LOCAI SALES TAX CODE IS J105 I I 1/�/Vl/ � <br /> I hem by ccrt�/y t lia�I havc mo Aan J cro�nincd f h�s app hcn fron an d tirio:v I hc snmc In be fn�e anJ I _.-- `�—- _-- --- i <br /> , correc( All provisrnns ul laws and orJurance�s govrrrrrnq Ih�s type o!Knrh �rrll be comple(ed - - --- -- - - --- � <br /> �� �vhefhcr specdied heiein or nol 1 hr grdrrGny ol a pcirnn does nof nmsurne lo give auflwnfy m PERMIT# I <br /> violale or cancel fhe piovision.a ol any nthei slafe o�local law mgWaGng consfnrehon or Ihe � n � � I � ' 0...� . ( <br /> perfnrrnance ol conslnidion Thaf I arn aufhontrd by fhr, owner nl Uus prupci}y lo pcAonn(hc � <� � <br /> wnrA lor whrch app6caf�on rs made and I cornply isdh pre Sfafe Conhaclors Law iB 27 RCW anJ 1� , <br /> J 96 700 WrI C. � <br /> � I <br /> ���/�`. , ;,��/,�'/ _�� �7�� 7— �-�-- -- -- <br /> �S���a�ure � Datc <br /> „e�. .. . ..._� <br /> i <br />