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10/30/2009 07:04 4254B85288 PAGE 01/02 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERE7T PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT,WA 98201 �D _,3p—�9 <br /> 425-257-8810 - FAX425-257-8857–www.everetlwa.org � �Q ��_ISZ <br /> I <br /> APPLICATONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> /�c��� <br /> �.f�D� t�wrr'r �1z/E <br /> PROJECT ADDRESS <br /> �,�y� Mail Addre.s �Ctly Stalo2lp Pha^� <br /> �-,re vF fi�+w- !G <br /> u L ({�wr7T'�f,/E �r.r'►Z�fT �Z�$f <br /> Tenanl Mnil Addresa Gty Sule2lp Phonc <br /> 2 53 <br /> l�J: �t�a1.'-r Se7t��c.n 1/�'L ti iPs��tf•.�:+• �f10Y' O:i7ft'6�. k��F ihi�l 3�7- -Ilfr1� <br /> Electrical Contractor Maii ntltlross Clry State2lp Phono <br /> ��7�s�syv��zvs <br /> /D A'�. Ot� <br /> State license Number Contract Price of Wa�k <br /> PsK 11i1,x 253.?,'}�''111+� <br /> Proposed Usc of Building ConWd Persan (Plan Revlew} <br /> Dcsr,�iptlon ot Work to Be Done: Ul�i4Q'lpE G�/S7N�'' '�� '�'`'��� 5�y�� <br /> NOTE: WIRING IN NON-DWELLINGS IS R�QUIRED TO �E <br /> 6E IN RACEWAYS,MC OR AC CABI.E. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS:106 <br /> f herobY ceHiry thaf 1 ha�o rc�d end mxsmined fhis epplicafion and kno�v the seme fo be true and <br /> crorrcct. A11 provlsions ollaws arn1 ordmsnces goveming fhis fype o�f wrork witl be cromplefed <br /> v o af@ oi canceldlie p�io slcns ol any other stato orfxal a�iv reau/atn 9�nettiC�t/On o�r theY t� <br /> pedormsntt>ofconctruction. Yhat I em auehodsod 6y;he owner of this p�operty to porform the <br /> �eork Ior which applicatron�s msde and I compty with the Sfoto Contrnclors Le�v iB.27 RCW and <br /> 296.200 4YAC. <br /> �i ,.c'�n /o•io- b9 <br /> Slgnature— ` uate <br /> i2 <br /> ��� i� <br />