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May-11-09 11 :23A P.03 <br /> / <br /> �� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT F�ERMIT SERVICES � 0 9os�0 5 8 <br /> 3200 CEDAR STREET, EVERET7,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www•everettwa.org ` 6 _ �i -aq <br /> APPUCATIONS ARE ACCEFTED FROM 8 AM TO 4 PM <br /> ��s,� � �i�o�T n,n _ <br /> PROJECT ADORESS <br /> M��� �rwnrr��1M <br /> owrmr n�.,n naaress C�h `���/��P . �1R <br /> �� __m_.9/2��,__ ._.._� <br /> Tenant Mad Address�-�—'_' ' Clty Sta1WZW �� ?Iwnrs <br /> ���._1F 1__ ._ 3 ,i/ !"r G _1�U k'u _.lBf'.�ai_ ._._ 13�,Z1�— <br /> ElaclncalConiracWr MaitAOtlress Cily 61atWLiV fMww <br /> Frh.�,��1�v z c.N <br /> State License Number Contract Pnca of Work <br /> S�tZ _.._ .. <br /> Proposed Use ot BulWing GOMect Pe�son (Plen Revlew) <br /> Desr.ription ot Work to Ro Pon�: .,_,,,��.N.,.�(11,�. ~���� ��/V�'- -�-�--�-�..............�.—_ <br /> NOTE: WIRING IN NON-OW ELLINGS IS REQUIFtED 70 � <br /> BE IN RACEWAYS, MC OR AC CABLE. 7� fa2 • <br /> T � <br /> CITY OF EVERETT LOCAL SAI,E8 TIJ(COOH t9 3108 <br /> !hereAy certi/y Uiaf 1 heve reaU end ezemMed NNsep plioallon and know(I�o sarta fo be lrue and <br /> coRect. Ad provisions ot laws and ortllnenees pove9f/np thfs fype pf worM wil!be cumpleted <br /> wheihnr spacAierl�erein or nof. 7Ae qianUnp 61 a pem�7f does no( ae4wne to pive euthorily fo <br /> vlWefe or ceneel Bie Pro•vision of arry ofiw stafo or/oc�f lew repufi6ny conatruceon or d�e <br /> peAormance ol cons`roctitin. �hef/am au�hodze�V by Me ownor o/!his property to peAortn the <br /> work loi whlch ap{N eUai is mndr,and f comply wirh the Statc Conrmcrors Law 18.27 RCW enU � <br /> 296.200 WA <br /> /� , <br /> ^.1 ___�e;f n ''_ �S <br /> � ��9m � ---....- ------ oa�� (� f1� <br /> / � <br />