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FBUM :Gick H��w3rd ? SunS Glcctr FR�•: N�. ..�'S7',65HS5 Lc:. 22 2015 1"�: :�FM P2 <br /> ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> I 3200 CEDAR STREET, EVERETT. WA 98201 <br /> 425-257-8010 - FAX 425-257-8857 -www.evetettwa.gov <br /> Cy� S10vI� I <br /> � �p ��}� i5 <br /> � � 1 � S. Jca��-r�,- (�v�- <br /> PROJECT ADDRESS <br /> � r \'�.., s� a � 5.��^�.✓;�- �ve �:�Jer�-l1 ��!1� �.c� '� <br /> p,.rt,�r Mad Adaress Gry SlatelZip Phane <br /> I Tenarrt MeilACaresa Gty SKnNLP Phone ,� <br /> �-l�S- �'1�• l�t��S <br /> I ,� ' k`-�tit�x� c�:� 15��. c�1ti',� �06�� c1�( � 1.��:�� UJ�1 �1 '�1�4. <br /> I Electncai Cont�ador Mod Atlarnia Ciiy S'n�e/Lp �� <br /> � I� Ic�NSG � 3� iz�� _bl�lu�� <br /> State Licvnse NumCer(reqmre0) City o�Everr.tt�usine55 l.icense NUmber(roquireA) <br /> S�C.�_�.�ic.� � n� ��U ^ <br /> �I Prnpose0 Use of OuJding ContraU Pdee o!Work �,.,�a S - �1�1 S" � �1 �TS <br /> ' JeN�����r �1e �4-Xc�� <br /> ISqunre Footape pf resldrntial new wnsuuchon, remcdel or otltl�hon) Co1n�L�cl PersoNContad Number�Emotl <br /> � r\St�� � e v..����-c r E'''c , • C�SV`� <br /> NumW++of dovicc.p��va voltngo) <br /> D��scriptwn ol Work to Bc Done� �(i� �1 �Q d c c -LC c�' ���1P �� I � �)(�\�0`�- �.�l V '-�r— <br /> � -v-i`�����_(?-L.�.11. �C. ��„�Ct�1]L.Y ` ,l� �l� �'�-�--T�l ' t--���� C,�`T <br /> ��J�� '�� ;ji1n�_.�,�;�C l."�'U:5__-AS Gl��f C ;:�"C.C.�.. <br /> rc� — <br /> CITV OF EVEFETT LOCAL BALOS TA1(CODE IS J105 ."�] � ��D _� <br /> i <br /> /hereby ceRrry thaf I hove road anA eromrrretl fhis nppllcnfron and know the semu ta be huo nntl <br /> cortecf. All pivvisians ot laws anJ orclinnnces,qovemurg(his lypo 07 worlr xNl bo complofcd � -- <br /> whether spucdied heroin or nof. Tlru gran6ng of n pumut does rtot prosume tu give sulhonry�b PCRMI l t� <br /> violafo or cancei Iho pronsions ol any ofhcrsa�lo orlocel Inw rtrgulaling consvurtinn or Ih� � <br /> perR�mtanca oI wnafnic(ron 7hu1 I arn uuthoriacd Dy the avner d fhfs pm�u7y!o p�rlunn!he I����" I g� <br /> �vork 1w which opphcaPon is made und I romply wrfh fhe Slefe i,nnfrar,fors L,w 18.27 RCW and _ <br /> i 796 Z00 WAC. <br /> ;� � ' �1 ���a�( � �- <br /> � — <br /> Sipnn Dnlo <br /> � <br /> � <br /> ��mEY.SC-J Cd'J62011 <br />