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� i <br /> � EL�C7RIC�4L PERMIT APPLIC:AT'ION � <br /> CITY OF EVERETT PERMIl� SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 V� ` � 3 � <br /> � 425-257-8810 - FAX425-257-8857—www.everettwa.org o�L I <br /> IAPPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM r�3�� ` ' a( I <br /> � i <br /> � <br /> i �— (�10� `ij IWO S� �'Jer'C-�� MRII �C�� 'I �I .� I <br /> � PROJEC7qDDRESS I <br /> I <br /> Owno� Mail Atldress I <br /> Gity Stnte2lp Phpne <br /> �I.oBA'L 3vS/w�SS Soi. vTlve✓S 1��, �,��E rK� W �{-��s �v�r�I�- W�-- i <br /> TynaOt MallAddress City Stete2lp Ph�ne <br /> f�Cl i"� ���c�r,c ll.� l�x:oz Av,�,�� I-1Ut +�v 3�-Irrr S�- 1A%R- 9s I33 �"`' �j°y <br /> �4 7 <br /> I ElectflCel Cofll�Oc(pf hlall 4qdress Ciy Slete/Zip Phone I <br /> I /1����L�L / �r���r d �(YJ _ OfJ '— I <br /> S�ete License Number Contract Price of Work <br /> ����G� ti t�l 1' Zab-9o:�Y9c7 <br /> Proposed Use of Buildmg Conla t�an Review) <br /> `t� i � <br /> Square Foo(age pf residenUal new construction, remotlel or addi(ion) <br /> iDescription of Work to Be Done: �1 ��Ur� `(�� q y: �� P�C/ S�n-� �i 5��w� /��� � <br /> C'k/� !'�OW e-✓ T�Y 11Q-w ►'t' !'Ci0 '��'—Q�S' <br /> I _ _, <br /> NOTE; WIRING IN NON-pWELLINGS IS REqUIRED TO FEE <br /> BE W RACEWAYS, MC OR AC CAB�[. <br /> / Z,� -�-j`� <br /> I I CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 `� <br /> II heroby certi(y tho7/have�oad and oxamined fhis application onG kno�v the same to be true and <br /> r.or�oct A/l provisions of laws and ordinances govemmy ihis type o!work�vill be com letod � i <br /> � �vhether specdred hereln or not The grantinq of a permit does notp resume to yive aufhonry to � I �J�- " I ? <br /> iviolate or cance/the Provislons ol any o�Ner state or/oca/law iequlating construction o�tno <br /> perfom�a ol consWction. Thaf I am outhorized by fhe owner ol this property to pedo�m the <br /> wo�k(or h h appl/cation Is made and I comply�vifh the Stat3 ConVactors Law 18.27 RCW anq <br /> 296. W C. <br /> � <br /> � LI/`, l3 <br /> SlgnaWre Dafe <br /> � <br /> > <br /> i <br />