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Jan-26-07 10 : 36A . P . U1 <br /> ���� � �7 <br /> ELECTRICAL PEIRMIT APPLICAT{ON <br /> CITY OF EVERETT I�ERM11' SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98Z01 <br /> 425-257•8810 - FAX 425-267-F3857 —www.evereftwa.org <br /> ApPLICATIONS ARE ACC[PTHD FROM 8 AM TO 4 PM <br /> ��� z � ��e� �- �s _ <br /> PROJECT AODRESS <br /> Owner Mail Adaress Cuy SwlelZip �C`{'hone <br /> 2h�u � ,a 7�i r�v �'�� � ca��Y' �/ZS �ii G�fi 9D'i� , Yy'� - Y�'L <br /> Ten:fnl Mall Address C�ty StalrJZip Uz� Phone <br /> /, <br /> ��y � �� <br /> �Yc.4M ��K�� s' .S 34�.� Fv .du _ku 9/�,� i 4� <br /> Eleclrical ContraGor Mail AJdress City SUe/Zip Fhone <br /> ��L a-N�.t /y:L L. �0 2� /v o � <br /> State Licenso Numb_r ConLact Pdce a(Work <br /> �O✓LI iL _. <br /> Propused Uso e(Buildlny Conlact Person (Plan Roview) <br /> �oficription of Wotk lo Su Uune: 3U �' �b�/�Il� � �I�L.0 � -�J�/�V��. hdd��' <br /> NOTE: WIRING IN NON•DWELlING515 REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �3G e'� <br /> U <br /> CITY OF EVERETT LOCAI SALES TAX COD[IS 31tl5 <br /> 1 heroby cerfity thr�P 1 have read and examinr.d this applicatron unJ know tho same to be frue and <br /> correcl. Af/provisions y/laws ond orUinances povdrnm,q ihls(1'P�ol�+�od<wi0 be corrrplefeA <br /> whPthorspecihed hero�n or not 77�e glan6ng o7 a pemrrt tlops nr,f presurne fo�ivo authonly to <br /> vio�ale or tancel ihn provisiorl5 of any o16er sfafe or bcal Ww re,yuletinp consVucLon oi fhe <br /> pr.rforrnanr.o o!construcfitin. That I am suthedzed by f�n ov:nei o�ihis prr.peAy to pedorm iho <br /> work !or which application is n7aQn and 1 canply�vith the S7ule ConGaCfors Len• 1D.27 RCW and <br /> 2y6 200 WA� <br /> S pnatut� / �0/� <br /> �},i ��1 <br /> � <br />