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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERtVIIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />% Z —� � j <br />2 L-��3i� a�� <br />laU I sE �vcrett r�+ll l�io.� �5�,,�-e. �2S E�.�Ltf W`f} 98zo8 <br />PROJECT ADDRESS • <br />ka11 <br />� <br />SE E�.cr�¢� 1'�la I I y�� �� 2 <br />� ., �, :_, � �'���,-tt �IA 9�Zo8 �i13 <br />� <br />Clry q <br />'1 ' <br />StnlefZlO Phone <br />� � <br />ISG1Mi.� SG�'�'-C, �AA'�c- �arn�- �/Vi� <br />Ienanl hL�B Addrass Cry ScatefLp Pbono <br />i UZS- �7 <br />�qorS 36+"� A� W+-Si" `�303E� "70�0 <br />i Y��l�. �IrcrlrJt, s��i'c t-1 �ynwboc, V,/t� <br />I� ElocVieal Conlraetor Mail A]dress Gry Smla2lp Phone <br />i <br />m�FLEtL'n�90�G <br />S:ate Llcenso Number <br />�is� �d �eafo�u�•rl in {'�'lall �'vucl Cr.:�.��� <br />Pmposed U,a of Building <br />SGuarc Feotepe pf mclAontial new construction, remodr.l or nddltlon) <br />Numbor of devices (If low wltnge) <br />I�,1l1 ,UU <br />�LU <br />Contr�ct Pnce o` Work <br />�ohn {-{�nrvtn�n bY <br />Contact Parcon (P!an Rr.�,ri��v) <br />(u'a.9.� � L.nY..�-+e J <br />DescnpUnn of 6'Vark to f3o Done� _!'�` '}tr�c k �u���nq � Glrivr.,-}� Z2O r�� i �i �-5 _ "1D l z0, � <br />T <br />�mtic_,—y- 120 -k, 7'LO ,��nc. o� -}�au.� i.a�n�+�,� � t-c.L�c�.ir. <br />�-- <br />CfT/ OF EVERETT I.00AL SALES TAX CODE IS 3705 <br />! �emby catily ff�at I have mud nnd exnmined fhis opplicafion and know the same fo Ae Wo and <br />wrroct. AI! provisions of lews and ordm:mces govennng lhis typc n( work wrll bo completed <br />whetheispeci�ed herein or noL The gmnfing o( n pertnil dous not pmsume to givr. outhonty to <br />vrolata orcancal (ho prcvisions ol any ofhcraWfo orlocal law rcgulnfing constnict/on o�tho <br />per/ormancc o/consWctlon. Tha! I am authonzed by fhC oNncrnl fhis proporty to perform fhe <br />�tirork !or which app�cation is madr and 1 a�mpfy wlfh fhe SYate Contraclors Law 10.27 RCW nnd <br />296.200 WAG i� . <br />12Jlco <br />REVi:[p Y�G�9 <br />10�� a�o <br />PERMITN <br />E13i2 -Il3 <br />