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05/10/:010 MON 11: 20 PA% 360 805 0287 NILNC CLECTRIC <br /> �003/003 <br /> ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5_io-�b <br /> 3200 CEDAR STFtEET, EVEI�ETT, WFl 98201 � 5 <br /> 425-257-8810 - FAX 4?.5-257•8857 -www everettwa.org C/Db S"D '� <br /> APPLICATIONS ARE ACCEPTED FkOM 8 AM TO 4 PM __ __ ___ <br /> � -�,nr7 �� �,./ l_�.. ,,�._., ��e�� �/ ��CJ — ��7 <br /> PROJECT ADURESS F-]J �ys�x _� �J� r„� � ���/�-l 3 <br /> ' S�����z_c c..,i� `�.J i�_. <br /> /�";�<' /r� C,U","''7'�-,���—, ----- StaieiLp Phnne <br /> � —�` N•a�iess �'�Y <br /> Owner '/ <br /> , � "/.�S ...5-7(„•' ,�5� <br /> (.) ?_ELU� _ <br /> obla2ip PFono <br /> Tc�ienl I.Inll IW W vaa CII/ . <br /> f��'�. /r'l1 �4'Y. •7✓' t Phone <br /> [lertriCul ConUeClor tdail Atldress �'�Y <br /> Slate2ip <br /> h� �G`'--- <br /> State I.ir,ense NumUcr <br /> Contrnct Prite ol Work <br /> i <br /> ��J'�� i � 1-r--[ �.��, .--c ��—^—S <br /> Proposetl Use ol Buildinc� Conlnd Person (Plan Review) <br /> - ;�� ,as� � 3s; <br /> � _ �' i.-r.s �. /� uiv�..1,— <br /> flesr.riPlion nf Wnrk tn Re Donn' / `" � •"`� � .-.. . ... -. <br /> - C. V l....�„-t l�.C�-c� <br /> �,�.1A1��.� �-✓ ,� �.� I � -� �.�`--. �-----__ <br /> -��- -- ,/ , : <br /> _ (J7J�/ _�_GG,!l�E+t .�/ G�.��( !'��J��.rtc� �•'�I_ <br /> ,f ! '—�—�� ' <br /> NOTL Wlf?ING IN NON-DWELLINGS IS REQUIR6D TO FE[ � <br /> 6G IN RACEWAYS, MC OR AC CA6LE <br /> CITY OF EVLRETT LOCAL SALES TAX CODE IS 3106 ( ,�) <br /> I huieby cer}dy fhat I hnve�c nd nnd e.earrrined Ihis appl�cafiori�nd Imow(ho samc lo be frue anrd �I � v`� <br /> ronecl All provrsions olla�vs an0 nrJinances yovermng fhis lype of��crk will be conrplefocl <br /> �th1.31C 0�C8 ICfBI�IIB�fJVIOSlOI15 0I A ly 0(hB�'��dlt�OleJCd11 a�v rrgu�alin3�onshi�cfion/or�fo eY fo <br /> I ��orlorrnance ol construchon 7hof I am aulhurr.ed hy Ihe c�vner o/lhis propertyW peilorm fhe <br /> u orN lCr whiilt flpphcafion is nrade and I CornF'Y��'�fh the SlalP ConfrAolois LA�•+ 10 2i RCW nnd <br /> � :uG �(.rp 4VAC <br /> / / � _ <br /> �% )i <br /> /.�.� ;ivl" "-� ` �/t�.y�.�___—J �� ��./ <br /> Si9r1 lure <br /> [�.ale �_'____ <br /> I <br /> i <br /> r <br /> . __._.__.._____"_'—'"_._—_'_-- <br /> —___"'__—_ <br />