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a�e: 2 of 2 09/2/2014 09 : 17 PM T0 : 14252578857 FROM : Donna 6arner PHO <br /> N2064915506 � — -- • <br /> ELECTRICAL PERMIT APPLIC�4TI�R� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I <br /> 425-257-8810 - FAX 425-257-8857 -www.evereltwa.org <br /> �`��`�y <br /> � C- l�o9 --a� � <br /> iosu iF��� Yi �v <br /> PROJECT ADDRESS <br /> Melinda Abrahamson 105t1 lG"' PI W �verett, WA 98204 206-948-(,p80 <br /> Owner Mad Address � <br /> City Statc2iP Phone <br /> Tenanl Mail AtlUres; Ci( <br /> Y Sl;nc/Zip Phone <br /> AMPEU Islectric P.O. Box 8(g i'svcrctt, WA 9$206 42�-583-6414 <br /> Elech�cBl Contractor fvinil Addres; — <br /> Gly Si�tc/Zlp Phonc <br /> � n,��i�Evc�v��o�na ws�,z <br /> State License Numbe�(rr�quired) City of Evemtt Business�icense Number(reqwretl) <br /> Sin�le Family Residencc <br /> Propnsed Use of Buddinq <br /> Cantrad Pricc ol Work <br /> Syuare Footage Qf resitlenlial new conslructioq remoAel or addition ��i���a-�������-5�+����`�R-hUR(L_.. '� <br /> ) Conlacl Person/Contact Numbeu6nail <br /> � IJumber af dovicos Qf lov�voltage) � <br /> oescdpi�on oi work to[te Done: __ _ Listall circiiit�for ducUess heat n��m�_ _ _ <br /> FCE -- � - -- <br /> CITY OF [VERETT LOCAL SAI.FS TAX COD61S J7p5 <br /> l hcicby certdy lhat/Iravo rc�d ond examined this applir.�nlion and kriow(he same fo he fn�e and �� ' I <br /> correcf. 1111 provis�ons o/laws and ordinnnr,�s�oveminy Ih-s type ol woilc will bc r,omplefn(f ---�'---�--� <br /> whethr.r;per,ified hnrr.in or not The qinnting ol o perrnit docs nnt prasume fo yive aufhorrty fo PLRMIT(t �_--� �—��--_� <br /> viohlo or r.ancd Ihc prowsions o!uny olhcr�(a(c or loCal law 2gulahnq coris(rur,lion or Ihe / <br /> performanco oI consf�ur.fion Tha!I am aufhorizrid by(hr. ownnro/Ihis propoity(o porlorm th� E � /y )1G? _ —/, � <br /> worh lo�which applica(ion is madc and I conrply wifh(he Slalo Con�raclurs Law 1U.77 RCW vnd � U � �/V <br /> 296.200 INAC. <br /> � � `-- �� 1�i0 l / __— <br /> a�uro ��, <br /> IHLVC.tUnlo2r^,ma I <br /> _'_ - _.. . ._ <br /> . —. .__._ —" _ <br /> . _ _ __ . _. __.__.____' ' <br />