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210 109TH PL SE 2016-01-01 MF Import
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210 109TH PL SE 2016-01-01 MF Import
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Last modified
4/14/2017 4:25:04 PM
Creation date
4/14/2017 4:25:02 PM
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Template:
Address Document
Street Name
109TH PL SE
Street Number
210
Imported From Microfiche
Yes
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F�F�CP9 :W�e�.�� Ele�:tr�c Ltc n FRY 17U. :36G�6914838 I 21 2011 119:0aF1h1 F'2 <br /> ELECT�2ICAL PERMI�' APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32UU CEDAr2 S iREET. EVERETT, '.NA 98201 ' ' `o���r <br /> 425-257-tSr31U - FAX 425-257-8857 -www.everethva.org y <br /> ApPLICA710N3 AHE ACCEPTED FROM 0 AM TO 4 PM C�III `I 3 / <br /> �/D - /09'� �L.5� __ <br /> PROJECT ADDRESS <br /> .�-�1 � a�o - io� Pt.� �p�! c�JA �as���s�ra <br /> (hvnr.r �1ail Addres� Cily Slal�/Lv Phont <br /> Tr.r10n1 - ---�- �7ailAtldrMS Cdy SIIfn'Zi0 �'h�'�o <br /> ���v E'iS /310� �D. .(-�n��C7P��lrr- us��.�1-L—`�25� — <br /> [Ir.clrical Contractor �.1n�1 AAdrms C�ty Siate�l.�o�b�bq�� �hone <br /> � <br /> IF.CU �/SC%TPCA. ��,tl<..---- `—�`�� <br /> Statu Licons?Number Cantrar.t Adce of WorY <br /> [L,W../(/ <br /> Vmpose� ls ol � uildlnp Cnntacl Ftv;,on (Pian Review) <br /> D�ccnptlon oi Work 1�Pe Dnne: _{f-h(J'__[�� � ��.—YSG�-'�"'"-� <br /> ����t�-�o�s _��� rt�ou.7,�,!- 1,,�- 1�,�Gw� ` — <br /> NOTL. WIRING IN NON-DWELLINGS IS RE(�UIRED TO FEF <br /> RE W �taGLW�YS. A1C URnC CAf3LE. <br /> � <br /> CITY O�EVERCTf IACAI_ SnLES TOJ(CODE 19 3106 <br /> I hnrrfry ce�Lly thnt 1 ha�P���ad and PxdminPd�his epp6cebon and knuw fhu SarrrdW bdVUB And <br /> cnn?r( All provisiuns n!�s�4s and aNmunros gove�nutg fhic type ol Hork ndl Ge cornplefed <br /> whe+(hr•i sP��:�(�r��l heieu�n�nof 7hn�rnn(iny��!a pennrt dues nui presuaie fo pive aul/lonty fo <br /> ���ulafei a cnnce. fhr �iov�sions o(any other stnlc oi local/uw�royu�aliny consVuchon oi the <br /> pnrlorrnnnce ol cvns�n�c6vn lnaf I arn aufhnnzed hy(hr nwnm ul Ilris �opurty(o pydonn(fre <br /> , wof6 lor whi�l npph�nM1��n is mnAe xnA I cpmply wrth fhiv Slale COnbec urs(.�w in.17 RCtN nnd <br /> '� 2yU.2U0 N!1 .. <br /> '-� t � � �U�^_��-` - //-a./ �/f -- � �� � � � - l <br /> __ ;iynanlrc D'dIe <br /> I <br /> —��.�_—_." _—�_—���_—_` ._�.���--___ <br /> j _......_. ... _.. ... . ".__ <br />
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