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ELECTRICA.L PERMIT APPLICATI�N <br /> CITY OF EVERETT PERIV�IT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> -725-257-8810 - FAX 425-257-8857 -www.everettwa.org 5 `-7 ,,, C� <br /> ��so S---a� <br /> 10529 19ih Ave Wes�Everell Wa 9820n <br /> PROJECT ADDRESS <br /> Andy Pettit i 0529 13th Ave W Everett Wa. 98204 425-327-3452 <br /> Owner MailAddress C�ty State2�p �'none <br /> nla nla nra Ma nq . <br /> T�nant A1ail Ac�ress Gty Siaicl7�V �'nonc i <br /> 1001 cooper pt. rd. SW 140-290 <br /> c^��rt G^��^v Today olympia wa 98502 888-405-8689 <br /> ElectncalContrador ldailnUtlress Gty Siatc2�p F��onc <br /> smartet869rj 052463 <br /> State License Number(reqwred) City ol Everetl Business License Number(reqmred) <br /> n/a 30,000 <br /> Proposed Use of Bwltling Conirac�Pricr� of Work <br /> �remy o�.vlc I <br /> ph�360�360-265�1�42 <br /> 1500 <br /> em�il-'cr1 emyh(�ilsmanenc�9ylodayncl _ <br /> Square Footage Qt residential new construchon, remodel or atlddion) Contact Person/Conlac� NumbedEmail <br /> nla <br /> N�.imber of devices Qf low vohage) <br /> Ins�allalion oi Pv;olar system and relaleA wirinq n ',2kw wuh micro inveners conlaining auto shul dov+n. <br /> Descriphon of Work to Be Done� _ <br /> � <br /> FE[ I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS ]105 r� �j I <br /> VI I <br /> I hmeUy cerfJy fha11 have�ead and examinr.d this apphcafion and knov�the same lo be Iruo and J <br /> correcl All p�ovisions ollaws and mdmances governmg Ihis lype o!work wdl be complofed — <br /> �vho(hcr specdicd horem or not Thc granfing nl a peimif does not presume to 9ive aufhority fa PERMITR <br /> violalo or cancel Ihe p�ovisicns o!any ofher sla(e or local law regula(ing consfrucfion o�fhn ^ � l O�J O�� <br /> ��er(on;iance ol cans(ruchon. 7haf I am aufho�ized Gy Ihe owner o/fhis property fo perlorm fhe t �n <br /> woik Ior which app�ication is made and 1 comnly w�th Ihe Slato Conl�actors La�v 78.27 RCW and � <br /> 296200 WAC <br /> ��)�����- 5nns <br /> t Sign� rc D��e <br /> nt vitrn nsr,.r.ma <br />