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ELECTRICAL PERMIT A�PLICATION <br />CITY OF EVERETT PF_RMIT SERVECES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — u/ w uJ -C �'���T'`• w�z Jv ✓ <br />Cltv..� I'. LVCrr�-f��S �GVB-rG%�' UJ2�0✓ . <br />l l�/ u Np�N �-�5io--��> <br />PROJECT ADDRESS f Q `a"i �� � <br />�kF1 P� Ni�%� � �J`� <br />0':rnef Nailllddress <br />G�w,Nov��v� G{l.r',. <br />Tenant Malt Addrcss <br />City <br />ciry <br />�`�P �%�Zo� <br />StalrJZip <br />StatclLp <br />Phone <br />Phone <br />f�C'�v.�n('_ tLc��12iL Pb Do,c `i$�� �ir"1,L�>N`� LJ� ���ilCti�3 �`!Z>`%EZ2�2ei2. <br />ElectncalContracror ldallAddtess Ciry Slate2ip Phone <br />l��' �pu�E z 3�'� ��i <br />State License Number (required) <br />F�v��.;�t��ts <br />Propased Use of Building <br />Square Foolage (If residenlial new construction, remodel or addition) <br />Number of devices Ql low voltage) <br />,�. �, y <br />City of F.verett Business license Number (required) <br />� 2c� o� <br />Coniract Pnce of Work <br />� S C'L�S.R-S11J Tsc'Ix.o9awM �. �v..�4Nlt�C <br />Gontact PerscNContact Numhcr/cmail <br />Descnption of Work to Be Done: _ �.C.SM`T1L/ C1�(j�(,'r SAV � r� � �1^„��ZryH f� G� �'Gr1�" S <br />J <br />_ �.ra't� Fnrs � �Na:�i:c K=,�>S r Z c i�L�-., � i S <br />CITY OF EVERETT LOCAL SALES TAX C �Dc IS 3105 <br />l hereGy certily fhat ! have iead and exam,ned fhl;� applicafioa and knor� (he same (0 6e We and <br />wnec(. A/l piuvisions o/laws and ordinances goveming this fype o( woric �vill be comple(ed <br />whetherspeci(ed hemin ornoL The granfing cl a permi! does not pmsume fo give authoRty to <br />vio/afe o� cancel fhe provisions o( any other stai �_ or foca/ /aw iegulating construction or fhe <br />pedormance ol consfruc(ion. Thaf I am au(horrea by the ou�ner o/this property to perlorm the <br />work !or whlch applicatron is made and I comF;'y with Ihe Sfate Confractors Law 18.27 RCW and <br />296200 WAC. <br />PEE <br />��,�° <br />PERMIT� <br />Ei51b' 1�'I <br />_e.ra:oor.ro.zr ____—_�� LL 70 L��� --- ------------------� <br />