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�� <br /> -- — —�— � <br /> ELF�TRICAL �'ERMIT APPLICATION <br /> CITY OF E`•.�ERETT PERMIT SERVICES <br /> 320C :EDF R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - ��AX 425-257-8857 —wnNw.everettwa.org <br /> (o�l f � CAuI/'�lh� � U c <br /> PROJECT ADDRESS <br /> P,FS ��TMf�r �g�o cac��rs�� A�� Eu�� wA . 9g�3 2�-�is-s��> <br /> O�vner �lail Adtlress Cdy StatelZ�p Phone <br /> I Tenan� `:adAtltlress Cdy State'Z�p Phonc <br /> �, ���D��c� FN�Y Sr.f�lrtf r 1a2L8 M,a �i� ST' 6��� � t,��e_ 9koll yzS-rl'd/-9G�c <br /> ' Electncal Contractor r;,��i q���ess Cny Sea;e-Z p P�,ene <br /> ' SUND��Sa� ��B �' �oo. � <br /> �, State Licen;e Number Contract Pnce of Work <br /> � ��r�- <br /> Proposeo Use of Building Contacl Person (Plan Revlew) <br /> Squarc Footagc Qf residential new construction,remodel or addition) <br /> � Number of devices Qf low vollage) <br /> Descriplion ot Work to Be Done' _A�O/�U� �� N�� ���r � R �UG��f <br /> /,�'E,�TPv�� <br /> FEE �w� <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � �Vv <br /> I 1 he�eby certily fhaf 1 have read and examined fhis applicalion and know U�e same fo be frue and <br /> correcf All provisions olla�is and ortiinances governing Ihis type o/work will be completed <br /> �vhefher specified herein or noL The gran(ing ol a penni(does nof pmsume fo give aufhonty fo PERMITk <br /> violafe or cancel fhe pmvisions ol any ofher slale or local law regulating consfruction or the ^ � � f� - b�3 <br /> perfonnance o/cons(ruction. That 1 am aufhonzed by fhe owner of fhis property to perform!he t <br /> �aodc lor which appliwGon is made and 1 comply wdh fhe State Confracfors Law 78.27 RCW and <br /> 296 200 WAC <br /> � � i Z.-tr-I 3 <br /> S�gna r Date <br /> :[n'C:,�:� „ <br />