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11/1:/2009 THU 10: :G FA% 360 805 0287 NILNB HL6CTRIC �003/018 <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 11�/',�d9 <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org � ��/.0 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 7jC1U � � ..�. 1.../�'i� �� �Ui7�J />� .�.J�V a �/� - a_( <br /> PROJECTADDRESS <br /> "Tt-J2` /�JC 7NC•7 ���n-,�-�ati-}� <br /> Owne� MeilAddrese Clly SlelelZip Phone <br /> %-•�/N C� — <br /> TC�eM Mell Address CHy S�atelZlp Phona <br /> %����i�r L�-Z r°`� rn�� . �n.�l. � aS% �L� S7� SE� �9✓�v2��e: 1..A9 <br /> Electricel Conlracto� Mell Addrea� City Slate2ip Phone <br /> 9 8,��.� ? c v- HG �3 �-<�c. i7 Y� 3'7v a .' <br /> 1r1� L,�•c:L 7��� n�v <br /> Slale License Number Conlract Prica ol Work <br /> �-w-c.-77�/Ly <br /> Proposed Use of 8wlaing Contact Parson (Plan Revle•v) <br /> Descriplion of Work to Be Done: � � G f� I ,N�� U�(���JL •— I��t''��� ��� <br /> ��`��� -'7d✓�+7 l / !-f'J7N cW Q/3�`��L_S ' I ti s T)aZ C, I�CC.lJ C�r9TL . <br /> !�—�'�t2►'Z. � 12C.. i�v IL — (?-cvt S c:'� v l/L►rv(,� <br /> NOTE: WIRING IN NON-DW[LIINGS IS R[QUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 �0�.' I � , O�� <br /> 1 heroby certily 7hnf I have read and examined Ihis npplicafion nnd know fhe sama fo be Irue and <br /> corroct. All p!ovisions oJlaws ond oidinancos powmmg this fype olwork wl11 be complafed <br /> wholher specdicd herein ornof. The gronfing dl n pennit doe5 nof p�osume to plve eulhonfy fo <br /> violafe or cancel tha provisions ol any olher slafe or locnl law regu/slin construcYion or Ihe • <br /> pedormonce o/cons�ruc6on. Thal I am authonzed by(he owner ol thl�property fo pedorm the <br /> �vork/or whlch application Is mado and I comply wilh fhe Sfete Confractors Lew 18.27 RCW and <br /> 296.200 WAC. � /'�/ <br /> � G%�C� �/���"vJ'7� �� �i� d� <br /> Si ature ale <br />