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07/02/2007 KON 16: 10 Pax 3603839911 6ai1 El�etrie int. 0002/002 <br /> 07/02/2007 12:51 FAX 425 257� i7 EVERETT PEP.�II7 SERVICE��. �001/007 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857-www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �.u.�,lU�¢.�.,p �LtC-C-C,�`�OL. . <br /> �30� �en t�oo�. �,� �� t,A L o �, W l�}' � 8aZ 1 3 <br /> PROJECTAD�RESS <br /> � �1 � r 1'�i91"E12) wt.S 1�C%k D �D�,T �JJ.Oln"1"t ��� 9ga,� � <br /> Owflof MaOAdOreas Clty SIatULlp Phone <br /> � Iw <br /> TenaN MauAOdress Clry SGtelLp Phoee � <br /> S1F11L CLL-'n_Tftin, y 31�a383 -Uq1 � <br /> ��• qll �LWTC-R Rt� � _�Il�nnham� 1.����j8a <br /> ElectticalContrector J MaiIAAOress Gy 0'StateRlp Pnone <br /> s�.g11- � 1�0� D � �'�� . �9D.oD <br /> Slete License Numbef � Contract Price of Work <br /> �f� ,�„ ��.SS <br /> Proposed Use of duilding Contact Person (Plan Review) <br /> a <br /> Dnscrlptlon of Work to Be Done: aA ��.n � �yy� � �/Z , � � ) <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREP 70 FEE <br /> E3E IN RACElNAYS,MC OR AC CA6LE, 7� <br /> . ���� <br /> CI7Y OF EVERETT LOCAL SALES TAX CODE IS 9105 <br /> I heroby eertlry thet!havo reod and oremined thls applrcetion and know fhn seme fo be true and <br /> caroct. A!!provisions ollaws and ordinances goveming this fype o(woAc wiff be complofad <br /> whether speur�d herein or ncL R�e granGnp of a permrt does no:p resuma fo div�autho0ry to <br /> vloklfe or caneel fhes Orovlslons of any other Stat�a or local law rxpulutlnp eonsfrucffon or fhe <br /> perlarmancen/construcfion. Thnflamnufhodzedbyfheownerof(AlspfOpertytoperfomtthe <br /> work lvr whrch application is mado and 1 compty wRh tho Sf3fo Canfrac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> _^.��'-L--t n�'�,1cD01� � !n �� "� f <br /> SiP�tufe Dale <br /> FG7G 7 ��' � <br />