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__ � <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - PAX 425-257-8857 — W w uJ -E i��rc.'?a ww .�� / <br />� <br />� h./.. i i'. LV[! rCi'�e. e S� L� VGrLY�� EaJc�—� �J iI , <br />—7 _�-a5 <br />`C`l`� ����s� �i5a�--a�� <br />PROJECT ADDRESS <br />��1�1 Po ��/' I �j�17 <br />Owner Mail Address <br />CfZa,N�?V�t'w G:l?5�y. <br />Tenant Mail Adtlress <br />Ebrtiu—r-�' <br />Cily <br />Cily <br />L n� �l�Zol <br />Slatc/ZIp <br />StalelZip <br />Phonc <br />Pnone <br />lNlct��:�:�r ��Z�12iL �6 F,•u;r y��.� li!iP-l�t�ra�.,r� l�Jo, `1�L�D�'�3 �yli')872�2�,i2 <br />Eleclrical Contractor Mall ACdress Ciiy SlatelZip Phone <br />f���'•.��u�E � 3�� ��t ��c� y <br />State License Number (required) City of Everett �uslness License Number (requlred) <br />��jorar�rn�E,�s � i�'J �, °i <br />Ptoposed Use ol Building Contract Price of Work <br />Square Foolage Qf resldenlial new conslrucfion, remodel or addltion) <br />Number of device; (I( low voltage) <br />�'S G'1MS:ZSln1 r;{c-Nw9..�,�,kz�vw�i�:e,� <br />Coniact Person/Contact NumbedEmail <br />Descriplion of Work fo De Dona ���S�K�'1�1L� (��@�j,`� 5 AU W � /(,�1^uaLFYti L7�- G�- l-'� rlTs � <br />�� ��'T"LI �'� N S � ('Nl J ii,l'' iCv4l) S � C. � pr_ �.n � li <br />CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br />I hereby certJy fhaf I havo read and examined �his applicalion and {:now Uie same fo Gc fruc ond <br />covecL AI! provisions ollaws and ordinances gove�ning firis (yp� of �iork villl be comp/efed <br />whelherspecilied hcre/n urnoL The gran(Ing o/ a permi( does nof pmsume fo give au�hority (o <br />viulufe orcance! the provlslons o7any olhor sta�e or local la�v regulaling con5(�uc(lon o�lhe <br />peAormance o/consfruclion. 7haf / am aufhoiized Gy the oivnerolthis properiy fo peilorro fhe <br />viorklor whlch applicallon Is made and! comply �vi(h Ihc Sfa(c Contracfors Lav� 1t3.27 RCWand <br />296.200 Ih�AC. <br />Rcvaeooa,nertoi< ��'LL 7Tj <br />FEE <br />d�5�D,0o <br />PeRMrrrr <br />E 15b�- 2 � (� <br />