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Jul-01-10 04=57P <br />ELECTRICAL PE:RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREE i', EVERETT, WA 98201 <br />425•257-8810 - FAX 425-:?57-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCI:PTED FROM 8 AM TO 4 PM <br />� y� y ��M�<< o <br />PROJECT ADDRESS <br />P.O1 <br />y� S <br />3 � y 3a�y <br />�41�1�1 _ ..�.Y a.11ora ��a��� t��IF� .M�K�fiv�c �� [f�2.?�0 <br />Owner Mai! nddress Cily Slatc2;p Phonc <br />Tenant <br />Afafl AdrLess <br />City <br />titnle2iP Fhunr. <br />k�tAn�rO� ( f,.s �ko � � U �t �' � yZs �9 �l <br />.��L _ ...�_�'-�i �/ <br />EIr.UnC:ICon�rar.br A1ai�AdU�Nss City Slile.�Dp F'hone <br />Ns � Z L.f� <br />Slalc Lir.pnse Numhnr Conlracl Prir,e of Work <br />J/- /L1' <br />('rnppce� Use of Buildiny <br />Desr,ription of Work to Be Uunn� <br />—/ - �. ! �' �/ — <br />NOT�; WIRING IN NON-DWFILINGS IS R[QUIR[D TO <br />B[ M RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SAL[S TAX CODE IS 3105 <br />Conlacl Pcrson (Plan km•ie�v) <br />! hereby cert�lp thaf 17ievr. «aad nnd r.xnn7ined lhi5 appAc�fiJn and I;nOH'!hC 58rno tc be Vue anA <br />cnrretf Al! pmvisiuns o! law�.s and orJmooces pOvemm lhi.s rypr c! work wi!! Ge rompletpd <br />�shethnr SpPCilicd hr.rpiq o� nu7. l�hn c�igptinp o! a pemi�( does not >resurne to give aulhonty to <br />v�olafe or cancef fhe �rovisons ul any otfmr stete ur iocal law re_quI �tinp corrswction or �he <br />perl, rmance o(�onslrUCLon, That I ant a1dl�Uiized by fhe owner o! fhi5 pfOpeRy to paA0m1 (he <br />work !or whiCh �pplicafirn7 Is urade and ! r.ompfy witb thc Sta7e Con,'ractors Latv 18.27 RCW anJ <br />296 2UD WAC. / i7 � <br />FEE � <br />S� �� <br />�-4 <br />