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12�20i2012 18:42 FAS �25 257 87J1 CI1T OF E1�RETT �001 <br /> Dac 20 12 04:29p DC Electric Inc + 5-670-0817 p.Z <br /> _� <br /> i' <br /> ELEC'TRICAL PERMIT APPLICATION <br /> CITI�' OF EVERETT PERMIT SERVICES <br /> 82D0 CEDAR STREET, EVERETT, WA 88201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> NP�LICATIONS ARE ACGEPTE� FROM 8 AM TO 4 PM <br /> ,�c;5 �lu,,�� Rd � <br /> Z��H1:L-�,�-�,�v � �'ar�' $-€� <br /> PROJECT AODRBSS � <br /> i - <br /> I:' pwnef MaN�Addre�ss Cily StetelZ�jp �h0�e <br /> �— u;�7 Uf� �-35!1 <br /> `��,�"� /° N�-� f�8 Bb'S� � Ldrshl <br /> ,j���, Li Mall'�Adlrsss CAy Sla4Zp ph�� <br /> �,�__ Z <br /> �i �C� 7"{b!'7 CsYisQ� f�Y�l�� l� W�'�' '�l��l"� Ct�'d- <br /> , Eledritel Contractor Nni;Ad7ress G�y SIn.N�Jp Phane <br /> �f�[�G�-�� 1 �Z l� IV � � Q�"�/`'�y -- . <br /> Slate Llcense Number Contract Ptice of Work <br /> � ��� �A,�I�i� 9��D�'�, <br /> A�posr.d llse n7�ul Ing Gontect Person (Pien ReNew) <br /> � Squ¢re Footage Qt residenUal new consWcl�on,remodel or addition) <br /> �! De3cripuon af WuHc to ee 0ane�. �,_,������� � r`���� � ��v Vv �'= <br /> I` MrY��=F�'�"����..lra—�Ef�c�'�S �- <br /> � <br /> NOTE: WIRING IN NON-UWELLINOS IS REQUIRED TO f-EE <br /> BE IN RIICEWAYS, MC OR AC CA9LE. �'C, OO <br /> �, CITY OF NERGTT LOCAL SAL[8 7N(CODE IS 5105 ' <br /> f hertby cB�fi7y fhaf 1 h3vs rnad and r.xamined this apPWcetion enC krtOw(he 63mo!0 00 Wa and <br /> � rnrrer.t. All pmvisicv�s ollaWs And oroinances 8ovem�ng lhla type oAw�k w1U 6a completed <br /> whafner speci�ied herom or no7 Tha yrdntlr��Ia pemuf does notPresvme to giva aufhan7y to <br /> violaleorcancelthe rovis�onsolenynMersfeteorfocellawreqva6ngconstruclroqorUie <br /> pedcrma�ce o/rnnsPiucnop. rhaf�am aumorized ey the ow.,er ol Nls propeay ro peAortn 7he <br /> r which applMalien Is made and I eomply with fhe sYate Cnnhaciors Law is,27 RCW and <br /> 296.2 ' AC. <br /> /` f-z-2o.rl� <br /> �, yanalure . ete <br /> i <br />