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P_02 <br />Nav-24�-09 08:39A <br />ELEC1`RICAL PERMfT APPLICATION <br />CITY OF EVERE37 PERMIT SERVICES [I <br />3200 CEDAR STREET, EV�RETT, WA 98201 ��� a'i �� <br />425-257-f3810 - FAX 425-2:i7-8857 — aww�.everettwa.org �O9 �� � �(� 0 <br />APPLICATIONS ARE ACCEPTED FROM B�1M TO 4 PM <br />���� �?�/� .7,� - <br />PROJECT ADDR[SS <br />����.r �-�<< �7 3003 -��r� � <br />Ownef I�fall Addfess <br />Te�ant Meiil Address <br />p `� � <br />i!iA�(�' .G%`n�ri T ��ir/ii.c. <br />Conlmr.�Or Mall AJdre::s <br />�i���s � �f Z �,/� <br />SWIe Licnnsp Number <br />—� ✓ <br />Proposed Use of Building <br />Dc+scriplion nf WorY to Be Duno: _ !/ � G�j S J <br />,, -- <br />��✓r,- ������ --- <br />NOTE: WIRING IN NGN-D\NELLINGS IS REQUIRED TO <br />E3[ IN RNCEWAYS, MC OR AC CADLG. <br />CITY OP EVGR[77 LOCAL SALES TNC CO�E IS J105 <br />CUri�„� �f�j y C� � `�r1-� .�_S''--�3` <br />Cny <br />Cily <br />547loRlp <br />SlalelZfp <br />7�"�/' ( G �-� � <br />Ph7ne <br />Phone <br />y25- 2S r z <br />c�ry sir�i��z�� <br />� <br />__ � �J�' <br />Contract Price ol W ork <br />Conlact Porson (Plan Rr.viow) <br />! herohy corlil1'llinf 1 hUvo read anJ ezamincrd this applicut�on nnd hnow the same to be fruo and <br />corrocL All provislons of laws and ordinunces floverning fhis type oi' work wil/ bo cornpleied <br />whefhcr spod7leU herein w� noL TPe pranfinfl of , ��orrnd does nut nasume to prva au0icnty fo <br />vrolato or conce! tho `�rovlsions ol any other slato or lucaf law �eguloting r,onsfruC(ion or the <br />padanlance U/ constructiur. That 1 om authal_>eJ by tho owner o(fhis pro�70rty to perform thB <br />woik lor whicA appGcnhon is �u�de �nd 1 comply rAlh the Sta10 Con�rdetors Law 1 Q.27 RG W and <br />29G.200 WAC. . <br />tuna <br />�t. <br />FEE <br />Z <br />Phonc <br />