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5627 10TH DR W 2016-01-01 MF Import
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5627 10TH DR W 2016-01-01 MF Import
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Last modified
4/3/2017 8:06:39 AM
Creation date
4/3/2017 8:06:32 AM
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Template:
Address Document
Street Name
10TH DR W
Street Number
5627
Imported From Microfiche
Yes
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APPLICATION FUR �L�CTRICAL PERMI�' <br /> CITY OF EVERE;T <br /> BUILDING DMBION <br /> 3200 CEDnR STREET <br /> EVERETT,WA 98201 259-88iQ <br /> SII�ECT HOMFS 12811 8th AVE. '.J. �A-201 EVERE?1' [ti'A. 98204 <br /> Owuer <br /> Mail Address Ciry Stat�IZip Puone <br /> �� <br /> Tenant <br /> Mail Addews City State/Zip Phone <br /> i��i-3 - <br /> Elec(rical Contractor Mail Addre:s City Slate/Zip Phone State License No. <br /> NIA TFMPOAARY <br /> Contract Price of Wcrk Proposed Use of Building <br /> 56z7 10th DR. '.�. (LOT 2� ) <br /> Project Addr:ss <br /> Description of Work lo Be Done: T�ORARY <br /> NOTE:WAC 296-46-140 REQUIRES THAT PLANS FOR ELECTRICAL WORK AT EDUCATIONAL, INSTITUTIONAL OR <br /> HEALTH CARE FACILITIES BE APPROVED BY THE STATE OF WASHINGTON. APPLICANTS W1TiI SUCH JOBS <br /> MUST SHOW THE STATE APPROVEll PLANS BEFORE CITY OF EVERET PERIvIIT WILL BE ISSUED. <br /> NOTL:WI�itTNG IN NON-DWELLINGS IS REQUIREP TO BE IN hIETALLIC RACEWAYS (MC A1QD AC, ARE CABLES, <br /> NOT RACEWAYS). <br /> I 1IEREBY Ce.RTIFY THAT I H,AVE READ AND EXAD`_INED�HIS APPLICATIC�N AND KNOW THE SAME TO BE TRUE <br /> COMPLETED WITH �T'FIETHER 3PECIFIED HEP,EINDOR N'OT.�THE GT��'.ANTNGN F A PERM TED ES NORT PRESUME <br /> TO GIVE AUTHORITY TO VIOLATE OR CAP7CEL THE PROVISIOiJS OF ANY OTHER STATE OR LOCAL LAW <br /> OWNER OF THI3 PROP RTY TO PERFORM THE WORKCFOR WH CH APFLIIOATION IS M�AAND o OMPLY WITH <br /> THE STATE CONTRACTORS LAW 18.27 RCW AND 296.200 WAC. <br /> X Fee <br /> — Dale <br /> Signature � <br /> � � -/ <br /> �� � �i�oorr�isr9�> <br />
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