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. <br /> � �i�t�l7 g <br /> — --� <br /> ELECTRICAL PERMIT APF�LICATION <br /> CITY OF �VERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-E1810 - FfU: 425-257-8857 -www.everetiwa.org <br /> s`- a-D�-fs <br /> � iSo �`,:3 I <br /> i���o M��.,� C�� P�wY _ ('>,�,�o��� 2v� <br /> .� <br /> PROJECT ADDRESS 7 <br /> �tt,rc.�h �t� �R��r,rf;�S �� �x lo�il SKoRr:'�u� W� �$I�b <br /> Owner AtailAddress Cdy Slale2ip , Phone <br /> 6u���t e, ' <br /> Tenant R1atlAtlAiess C�ry StateiLp Phore <br /> �125' <br /> f R�ce Ei.ecr2ic I,�,c �61'�3 1�E (r8�` � . � -•12fJ �e'1�r�,,� ��n R�S2 4S`I-3bb5 I <br /> EleclricalConVattor �e�anqperess Giry Stale2�p Phone <br /> ��� aGLSo-,�G � G�-� 13� ; <br /> State License NumDer(ieQmreO) Gity of Everett Business License Mum6cr(requireo) ! <br /> E � �J�� W i <br /> Proposed Use of�uilclirg Conlracl Price of Work <br /> �HWS �ioeo �i'�•$- 4S'I- 3GF�i <br /> Square Footage(II resdential new consiruclion,remodel or addilion) Con�la�c,l PersonlContact NumberlEm�d � i <br /> I V j�C%� �d Of.CO eelu�nC . �.ON� <br /> r <br /> � <br /> ' Number ol devices(II low vollage) <br /> Description ol Work to P.e Done� <br /> L� h ��' w�' (J ,ey,-r- Cl�nn< ��bn {c� A �`..�.�G � 1/� C.411�J�` I <br /> -- �L�.� �_ ca,�� �rzs- ysy - 3�:s F, , _ v� - <br /> F�� —l <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 1105 I� I 5� I <br /> / II hereby ccrlAy fhaf I hare read an0 examined IhL^ apphcatton anr7 knoiv Ihe sarne to be lrue antl __ <br /> r.onect. A71 provi;ions o!laws and ortlinances 9overnmg lhis type of woik �vrll6o rompfr.led <br /> �vhethcr spedlletl herehi cr not The yranhn9 0�o perm�t docs nof presumc�o groe authonty to PER�4Cf8 <br /> violeM or cancci the prwi;ions oI any othcr sfatc or local law�cgulaling conslructron or�hc ^ � �O r _' I � <br /> peAormance ol consVuction. That I am authonzed by fhe owner o!fhis property fo peRorm Ihe t 7 <br /> work lor�+hich applrcnnen is made antl I compty a�db the Stafe Contracfors La�v 78 27 RCW and _,_ <br /> 296.200 WAC. <br /> � �� S,�i�;'f S' <br /> s�y��:������• u,i <br /> r.rv;ruc+A�:oara <br />