� N
<br /> �^?% ' -
<br />�,.�.� �• SEP-29-2a10 23:55 From: To:2578857 Paee:l�l
<br />'� �
<br /> �,��c _
<br /> � � � � . . � (p•����! ..
<br /> � r a� .'..�-. xs tfn1�
<br /> t =�� ELECTRICAL PERMIT APPLICATION �- _ ��
<br />: ,�.. ' { ,"tys':�;�
<br />~�� u �ITY OF EV�FtETT PERMIT SERVICES ��;;����•'
<br /> '��'� ,�� 3200 CEDAR STREET, EVERETT, WA 98201 �
<br /> ~��,, � 425-257-8610 - FAX 425-257-8857 —www.everetlwa.org
<br /> " ^�� APPLICA710NS ARE ACCEP7ED FROM 8 AM TO 4 PM
<br /> k'N��l'.t. � � _.,
<br /> y�. :"r3a.� '_ :G
<br /> a� ��
<br /> ,��,� : � . ' \�
<br /> n R �`W�+."' ., '�w'l�\ +.
<br />� k� 151� - �I fS�f�S-h'C��' , �; ;,;`j
<br /> � �y ,,,�r''��'
<br /> '�„�'` PROJECT ADDRESS I '" '�;'' I
<br /> vv����
<br /> y � . ,ii �..Ji
<br />^.� ,Y,y
<br /> d�a, . ' I � '..
<br /> i
<br /> QWnCf hddil Address Gty St31C/Zip � Phono
<br />����r � �� � t`�
<br /> � ;�`; �K ra���l� 5�i1/1�t.Q� ��(' 1��-7/�Q � ;
<br /> ,�::�.. . � ,���;,� �
<br /> , _ , . 7CnaN A1ai1 AdtlrLss City SlalelZip Phone �-���_�M1:,
<br /> �if,�,1.:
<br />� �� : ��,�ro� �r��;� aa� � �'��.c�ern.� �iP�P�- w� �i�20► �� -� 36.�_ '�� ' ����� ',
<br /> ..�
<br /> � �, , ,__
<br /> �a�.
<br /> '� +�;�- . � �leclricai Contraelur M�ii Add�:sc City S�ataiZiO P�one � t" �
<br />`�.��,�� �� 7 So��r P �c 9��� � � �, � �d ��� `"��,�� � ��,
<br /> �,r �
<br /> 1; y � i
<br /> +� State License Number Conlrar.l Price of Wark � ��.��.`�,���}} ;,
<br />� ' �. . . � ' ��n Sh�cti�-4� '��;
<br /> � '�' Icu�ern ;,� y
<br /> " r�;� Proposcd Use of BuIldlny Cont�ct Person (Plan Reviow) ;;�;;y
<br /> Ay` ' .L.. , ^:`�34
<br /> ,} ..r' �`' . I '�'!`fi7����,�
<br /> � \ 1�
<br />� aR�y o n
<br />� +4�'� D � �P�,Ur'r�-� 5�1`�11�
<br /> r"��,r ' i Description ot Work lo Be Done: ��,�,J _� ,�:�'{'�l
<br />`� �� — r , '�
<br /> r p�*y,� � � , '� p �
<br /> �. , `f.
<br /> , rrt'�
<br /> ' � � Cov�.�"a l d-�U���S� � r=� '��' �
<br /> .. . .. I
<br /> NO7E: W�RING IN NON-DWE�LINGS IS REQUIRED TO FEE �>• �
<br /> BE IN RACEWAYS, MC OR AC CABLE. i� `'
<br /> �''.
<br /> x' ..� „i,^�:�� � ' CITY OF EVERETT LOCAL SALES 7AX CODE IS 9105
<br /> ,^Wer±�.-.n i
<br />�i•-.,x;, i I hereby certily fhat 1 have read and exam(ned fhis epp6�ation and know tl;e same to be(rue and
<br /> :�:�., � i eorrect. �fl pruvisions ol laws and ordlnances po��zrning Lhis lypv of work will 4e compfetad __
<br />�� �i; wheUier specifiAH heiein oi r �t rho granNng oI a permd doos not resumo to yivo auihorily to
<br /> ,7. i violafe or can��. fhe provisior�s o(any o�her s(ate or locol fow reguPfing construction or the
<br /> „ poAormance c construc�ion. 'fhat I am authonzed by the nwner ol�hls properfy fo perlorm fha 4 � +�� '
<br /> wnrk!or whleh application is mado and I cornp/y with fhe Sfate Contrp�tors Law 18.27 RCLN and
<br />� '�°'' ��� 296.2 WAC. � ,j�,��
<br /> � ' �iU
<br />�� �; � �� ��a.C.�-��- �o �O '
<br /> �yy. . �
<br /> @�;� ;,�, ,
<br /> �]S]_,�� � Ih
<br />���SPM� ., � _ —_
<br /> , ; ����� �zS 9�7 1 5'� �� �� ` ��� '� ,
<br />�. ,».�; .+ _a i
<br /> � �,a�� �� , � �ii;�� .
<br /> �
<br /> ,�" � � ��•1�..�,f- Clft'10U�' �Ci,�t.�.9��jt, j ; <<
<br /> . �
<br /> ,
<br /> � �;� i
<br />. _--- ._.. ..._.... _ ._. .__. . _ -----____--------- ------- , .
<br /> � t' �.
<br /> ��ii`.f. i-,��.
<br /> .-, ti p ��"i;:��ii7
<br /> .,:.,
<br /> . . . . .. '�.;���w �n..io .m^: �c�w.�^+, � � �. � �S��{y
<br /> r �xl-'ql `t. •,. m;;_ 4���� � .
<br /> ... '�;�-1 v. '1q� y �}.��x'�•,� �l�U�.. t ;
<br /> . . _ _ .__ _ �,— _Ya_ M _.
<br />
|