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11/1.^/2009 THU 10� '.0 PA8 360 805 0.'87 NILNC CLCCTRIC m00'./018 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 I l - �� -O CI <br /> 425-257-6810 • FAX 425•257-8857 -www.everottwa.ory C p�j �� _ 0 87 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �oc� -3 c ✓. C',9 <:, ti�� ,<ui�,� _ �c ��t, �f c/U - l ( <br /> PROJECT ADDRBSS <br /> �-l�- %iJl 1ivG� C:�i��-I✓-'F�.�.��' <br /> Ownel fdailAJ�ress City Slatc/2ip Phona <br /> _/.?_�C /NC� �_ _ -- <br /> TBn3nt MailAJdies, City Slalci2ip Pliune <br /> 1•7/L/�L• L Z C"177�lC" . //v!. __ /7 �S 7 7` L %T SC� A'lun:�(��>C LJl9 <br /> f_IecUic�al Conlractor A^.ail AdJress Cily State/T.�p Fhonr <br /> �'�J'7,� 3 c �.:-- £�c• ; • �!G /> <br /> r��iL���-[�lio/ /'iv � �tv�o - <br /> SWIu Licenso Nwnber Con�racl Pnce of W�ik <br /> G./1�2�'7fv v�r- <br /> ProposeJ Use of 6uilding Contacl Person (Flan Poevin,v+) <br /> Uescuption of Woik to Bc Uonc�. C��G �7�JN L� U%�C/�/-Iz7C •- /,v s 77�ZL ILrL�-�! L�`'� � L, <br /> --- - ---- <br /> �u�?_ 2�L,:� C,9—rZ--�"7�-�-�?���—'�2 � 12C /hJIC . G�)N��-t.T7 _jl7 <br /> ��?C l.s'l'1�J �, _ /Joc-..L--�' �` �/1v��nc�-' C.o.� 17� ;T Fv �2. ----- <br /> l..J G1q H�1 Ui'�! C; ATI�J/� �I'/�/!?/C�. <br /> IJO'IE. WIRING IN NON-UW6LLINGS IS R�QUIRED TO F[E <br /> BC- IN RACL=WAYS, MC OR AC CADL[. <br /> �---- <br /> CITY OF C-V[RC•TT LOCAL SALLS TAX CODE IS 310G � U �� I ' � �+,� <br /> I hercGy cortily(h�f I havr,read nnd vanm�noAfhis apphcohon and knc�v fl;o samo fo bo fruy and <br /> conocf All provicions ollaws and o�d�iiancos uovoniinp Ihis ly�;a o/�sak�vi4 be cornpleterl <br /> ��d�efher specdied horoin or nof The gr�nGnq ol a percid does no!pracume lo grvo aulhcnty tu <br /> nola(e or CanCel Iho provisions ol3ny o;hPf 51 i(C Oi IOC�I Id4Y/o<Julaling consbuCtion o�fhe <br /> podornrance ol Cansfruc6on Tha!I am au(honmd Gy(ha onner olflris pruperty lo pe�leim the <br /> uoi!<!or�vincd.�ppGc�liun is madc and 1 comply iYdh 7hc S(atu Cnnfiactors Lmv 1d 27 RCW and <br /> .1cG ZUO LV.4C -�. <br /> ���� C.%vt',Y � ,..u�y._ ���'���) <br /> — Siyna :rc Ddlc <br />