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12%N5;2012 '_b: 33 4254854320 <br /> HILL ELECTRIC PAGE 02/62 <br /> II <br /> ( ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMtT SERVICES <br /> 3200 CEDAR STREE7, EVERET'Y, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www•everattwa.org <br /> APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> tz �b-� z <br /> �.—ia � a�o�/ <br /> � 0319 1�� r ort R d -E�efe��- <br /> PROJECTADDRESS � �l C� <br /> v <br /> Phone <br /> �,�� Mail Addre.�s . �. (�„_ � �— <br /> ��(�'r��., <br /> �� S 3� 2-I \o`-1tb` St S vJ �erei-r �� °� ff�oy Ph� <br /> Tenanl <br /> MailAddress GAy StalelLp <br /> �}� �� E�ec{�s�c_ i�o �1C IO�lS Woo��`nJ ��2 1nf� �'RO�Z <br /> ElecNlc21 ConttactOr Mail Addrebs <br /> Ciry 3tate2lP Phone <br /> l�1. L��EC���-i-S C3q � � 9 0� `'� <br /> Cantracl Pnce of Work <br /> Stat/e'�4icanse Number <br /> `�--�–�` `Y� �' Contact Person (Plan Review) <br /> Proposed Use of Buiitling <br /> Square Footage(If resldential new consWction,remodel or additlon) <br /> {� �v�- ��n R -�o o� m��c1n: ,�-e_ <br /> pescription of Work ta Be Dane: Ile1�-a�� �o`N C <br /> �, coi��rn�-Ie.l a-SO �ee o� <ese��- 1oc.atao <br /> E 2l " - 2_U <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAG�:WAYS,MC OR AC CABLE. (�Q C � <br /> ' —� t J <br /> CITY OF EVERETT LOCAL SALES TN(CODE 1S 3'105 <br /> I herab certily that I have read and examined this application and know the same tc be tnre and <br /> eorrecr AI!provisions o!laws and ordinances goveming th�s rype of work will be completed <br /> whether speciRed herein or.not. Lhe g�anting of a perm�t dves not presume to give authordy to <br /> violafe or cancel the�rovis�ons of any othe�state or local law regufating construcNon or the <br /> per/omoanee of tons ucflon. That I am authodzed by the awna-of this property to pertorm the <br /> 298.200 WAC.applicafion is made and I comply with the State Con!ractors Law?827 RCW and <br /> I o2—�'—� �� <br /> S na e Dale <br /> � <br />