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Apr-25-12 09- 11A P . O1 <br /> EL�CTRIC�L PERMIT ARPLICATION <br /> CITY OF EVERETT 1P�RMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425-257-8610 - FAX 425-2:i7-8857 —wvw✓.everettwa.org <br /> APPLICATIONS/1RE ACCEIaTED FROM 8 AM TO 4 PM <br /> '3���t gnQ�p��' - <br /> PROJECT AODRESS <br /> , �ha�I�a,A_R. LLL �Ct�.M � G•;�� � .`7`�S_�_�_�l�l <br /> O��rner Mail Nddress Gty State/Zlp �Ph`o9p <br /> /`Sr(/ <br /> �Sl'dl2% �uJk'i .�'!c� Bf2��d,0�+.�1�' �I/ 9'�'�r._/ Y4�9/ <br /> Tenan! Mail Addrecs City State2p (/�(' Pho�o <br /> ( <br /> !C l�-�9�l(i�lt�.,_,S�.S_ �v/ �'c V J41� �/ ' N '�D( '�� �/4 � <br /> Electrical ConUaclor Mail Address City State/Zip Phono I <br /> c3/ <br /> �� s� �yz�l� /, �oo � <br /> Steto Llconso Number Conttact Price of Work <br /> V/1[�t�.Gl V l2GAt, �/�7" �'�'/Q-�' <br /> Proposod Usa of 6uilding Contact Person (Plan Reviaw) <br /> �ascriptionofWarkWBe�una: /ZI/SL ���_f(��� � ���'I�U���, �lc�C� <br /> r -- <br /> .L.t.rz.�_�.�i — <br /> NOTE: WIRING IN NON-DW�LLINGS IS RE�UIR[DTO F�� <br /> BE IN RACCWAYS, h1C OR AC CABLE. s� <br /> �� <br /> CITY OF EVERETT LOCAI.SALES TAX CODE IS 3105 , r <br /> f hom6y cnili/y that I have rt;ed xnJ ex��n�lrmd fhls ap��llc�0on nnd M1now thu sama fo he frve end ��7 O(.�F — I� <br /> correc7. All pruNslons o(!aa's and adii�m�cos yovenuny tAis fyp�o��vc�k�vl1!bo eanpleted l <br /> whefherspecIDed heiein or nof. Tho y�snting o!e parrnrt doas nof 1 resunto to yivo aufhonty to <br /> vlolete cr cancel tho provision.r oI any of0er sfafa cr local Rttv rcgult.ting consWctlorr orlAe <br /> pe�fonnance ufconsiniclion. That I Hm s�uthonzeJ by fho ownor o/�h;s prupeMy to peifurnt tho __ <br /> wo�k-/orwNielrA 1'cnlionismvdeartiFFcomplywill�Iha�S(elrCwrlraclorsLewlB,�7�R6N'-nnd <br /> zss.zoo �vnc. / <br /> ��' ; r� r <br /> S�noWre ate <br />