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J5/07/2009 TtiU 13� 06 PAx C253551610 dutton cenon m001/001 <br /> � <br /> �—. <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5-7`"°9 <br /> 3200 CEDAR STREET, EVERETT, WA 9820� �;090 s'��IS <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> y s— 2�j � �3 c n f i'u 5 �T� c i,.��'-.. <br /> 300 3 w , CH S��'0 2oAD <br /> PROJECT ADDRESS <br /> 7.oc — <br /> I� b t� I,�- f �O . / �0 � �e N l�fo N [,�-� (v2_. _ y'7 9 _ c/ 14 a <br /> Owno� —� Mail AdJiess Clly Elete/Zip Phone <br /> TenAnl MallAddress Cily SlalelZlp f�hone <br /> , � a.5' <br /> 1 � `�°� N.�.a y!_� �.T� a <br /> � U7TD� � C N �r�P(C.. Spt.,,� w�A- (.� ,�.�i.� �.�+u c t.t:13 ��p�'"1 3 �t I-76 u <br /> Elecldcal Contraclor Mall Address ' Cit� Slate/Zip Phone <br /> 3 �"� <br /> �.�'rUEC 1371� _�oo , <br /> Slato Lic�nse Numbcr Conlract Price of Worh <br /> �fv� Ka+—�U �'(� C-1��2. Iti�1 �fa�G7G� ,(J��4C" <br /> Proposed Use o1 Duildinc� � Conlacl Person (Plan Review) <br /> Descripllon ol�Vork to�o Dono: __� ( S �0"�� � e '}�� ��w L� �-- Ta � LD�j _ <br /> �.,v .> /2G e�.w�..lfGr �'�7" Nhe,� G.�Cra-T7a.�.J <br /> , <br /> NOTE� W IRING IN NON-DW ELLINGS !S R[QUIRED TO FEE _ <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF[VERETT LOCAL SALES TAX CODE IS 3105 <br /> I�wreby cortil�fha(I havo read end exanrined Ihls aPP��cnfion and hnow fbn same fo Ge Irue end <br /> wr�act. �ll p�ovisions ollaws snd ordinences yoveinmg fhls f}�pe ol�so�k�rill�n complefed <br /> �shelhor specihod horeln or not Thu�rnntin�o/a pbrnul does nof presumo fo�ire euthority fo <br /> wolate or concel Ihe provislons o!ony ofher sfafe or local law re�u/oting consfruGlon or fhe % <br /> peifonnnnce o!construcflon. Thof I em euthorized by O�e mvner o/ihis property fo peAorm fhe ., <br /> work lur whlch npplfcaflon Is mndr end 1 comply tvifh Ihe Sfate Centrnctors La�v f0.27 RCW and � '�; <br /> 29ti.200 WAC. <br /> r� . =i <br /> � .� — S- �•- '� j , , <br /> , -,_.,..- , �� � <br /> Sio�=iWre Dala � � � - l <br /> i.!� ' ':! <br /> ; <br /> � <br />