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�4/P4/2�07 13:26 14256360964 AVIDEX PA6E 02/02 <br /> ELECTRI L PERMIT APPLICATION <br /> CITY OF E ERETT P�RMIT SERVICES <br /> � <br /> 3200 C[ AR STREET, EVERETT, WA 98201 4`� u <br /> 425-257•8810 - FAX 42;-257-A857 - www.everaltWa.o�9 (;b�70 y-031 <br /> APPLICATIO IS ARE ACCEPTFD FROM B AM TO A PM <br /> .�'��,�7� �,�� I , �/ �� (' : <br /> �ID WG'� G9)�►t�. �G/_L�}�A �g��� 7L �1�' <br /> pROJECT nDDRESS <br /> 3 03 <br /> '��Hc u Corovr��h'c� �D�' (..�st Cas?++0 �ol �.r�f, �•JA 9810� <br /> Vw�er Ma�l Atldress� O 1 C�ly Slate�Z�v Pnone <br /> 7 <br /> � ou�A�o��.__ tJ�s+ G� r,� 8 a <br /> Tanan Mall Adtlress cnv State�Z�p Pno�a <br /> (4?5)(p`tS' <br /> ��d�� l35S _ - �r� �. ��� '�uu,�,�� ��.� <br /> Electrical Contractor �.fa�i Addreee cn� S•eiaZp Phona <br /> ��� �(o GZ �= � ��� �� .� � l2 ,'�'?t.'�� <br /> Stale L�censa NumLer Ca�trect PfiGO of Work <br /> �NC�. Q <br /> Pruposed Use of Build'np Conlar.t PerSCn (Plan� <br /> Description ol Work!o Oe Done: �j7 � �i.� <br /> NOTE• WIftING IfJ NON�DWELLINGS IS R QUIRED TO FEE <br /> 6F IN F2AC[WAYS, MC OR AC CA E. �7�QQ <br /> 7 <br /> CI7Y OF EVER[TT LOCAL SALGS TAX CODE I' 9105 <br /> I hereby certily fhet I pave read end eamnined th�s appOcatiun end hnow(he sama to be frue end <br /> ron�cf All prowsrons o'laws and oNmances{7m �ming th/s typa or Hrork will be comp/eted <br /> �vhether spec�hod ho�oui or nUt Tbo grar,finq ol n �errrof does not �es:irna fn give euthonty fo <br /> � violate or cancel fhr.provisions o!eny otlrer sfate ��onl Inw�epuPtinp Con5Vuc6on o�fhe <br /> peAo�ntNnCe olcu��shur.trun Tliaf I am aufhcrizm by fhp o�vne�Of fhis piopeRy hJ perfOn]7(he <br /> �verk lo•whfCh ap�hCa6Gn�s maUa anu 1 co+nµy k 'h fPe Stafe ContrHciurs Law tA 77 Ri.4V end <br /> 786 200 WAC <br /> Y�2-�� �� � �31 <br /> SlQnaiurC Dtite ^ � �'. <br /> -- � `� ( � <br />