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11704 EVERGREEN WAY 2016-01-01 MF Import
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11704 EVERGREEN WAY 2016-01-01 MF Import
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Last modified
2/10/2017 11:56:01 AM
Creation date
2/10/2017 11:55:51 AM
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Address Document
Street Name
EVERGREEN WAY
Street Number
11704
Imported From Microfiche
Yes
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� � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3'�g., p9 <br /> 425-257-8810 - FAX 425-257-8857—www.evere�AAlpRrg <br /> �=05o3-��v <br /> AP 'LICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 11�U l CIw�( �� So�7"� <br /> PROJECT ADDRESS <br /> ����•s (V'���s�� l3'{2sP��-.s��.�l� E���-�ls ��� ���-G <br /> Owner Mail Address Ciry Stale/Zip Phone <br /> C��JG�i Ckeu(oti ll")Gy (�w7 4 �5�,�(1 �uzre� 1,,.(� <br /> Tenant MailAddress Ciry r. State2ip 3/:__ (� Phone <br /> �UUK/ V41�nc7v� C�' ���" <br /> Mt�u-�- l��������y � c-�� �� `Is��f� wt� �b2� 3 � 32r <br /> ElectricalContrac r ldailAddre`ss City State2ip Phone <br /> ���.�-e1�5Co l2C �( I� � <br /> State License Number Contrad Price ot Work <br /> �-s S-����� d3��l l �Y�.� <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> rI 5��( <br /> Descnption of Work to Be Done: ��U 1 `C ���� `� <br /> NOTC: WIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETI'LOCAL SALES TAX CODE IS 3105 <br /> I hereby ce.rtify fhat I have read and examined this application and know tho same to be true and ��b�� � �� <br /> correct. Al/provisions of laws and ordinances governing this typo o�work will be comp/eted <br /> whetherspecitied herein ornoL The granting o/a permd does not presume to give authonfy to �;-7�G( <br /> violate or cancal the provisions ol any other state or local law regu/ating construction or the � � <br /> peAormance ot construction. That I am aothonzed by the owner o(this propeRy to peAorm tbe ��__--- � <br /> work I^r which spplication is made and 1 comply with the Stafe Contractors Law 18.27 RCW and <br /> 296.2U0 WAC. <br /> . � <br /> �-� �� 3 ' � �'°�! - <br /> Sinnature Date <br />
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