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SEP-3�-c^0�9 19:26 From: To:2578957 Paee� l�l <br /> � i <br /> `\ <br /> ELECTRIC�L PERMIT APPLICATION <br /> ., . CITY OF EVERETT PERMIT SERVICES <br /> ,�,'; 3200 CEDAR S7REET, EVERETT. WA 98201 <br /> ' 425-257-8810 - FAX425-257-8857—www.evereltwa.org �0—�-09 <br /> . APPI.ICATlONS ARE ACCEPTED FROM 8 AM TO 4 PM � 09�{)—DD 2- <br /> -�;�a C���i �u� <br /> PROJECT ADDRESS <br /> Owner A1ail Address Cily Stale2lp Phone <br /> 7enanl Mall Addrese City Slate/Zip Phone <br /> ���;-�ro I �,i{;c ���I ��rn.i� �1QD'P$�- 1�N4 �1�20l �a� �6ss <br /> ElocUical COnlrador Matl AtldreRs City Stale2ip Phnne <br /> �So�z i P ��'��'D 7 <br /> State Licenso Number Conlract Price ol Work <br /> � F��� �'�, SY►�.�z�4�' <br /> Proposed Use ol Buildinp Contact, Person (Plan Review) <br /> Ooscription of Woi1c lo Lie Done: 1�t�Y� I�l-WC_ �(�'% ���v\ <br /> y - Ti" <br /> �� cov��"a / 11 d��l��e�'s�_.. <br /> NOTE: WIRING IN NON•DWEI.LINGS IS REC�UIRED TO FEE � <br /> BL IN RACLWAYS, MC OR AC CAE3LE. <br /> CITY OF EVERETT LOCAL SAIES 7AX CODE IS 3705 <br /> cC,h ( 0-- �2 <br /> !hereby certily fhot I have�ead and examinud fhrs appliwfion enJ kn�w tho same fo be true and � <br /> canocL A/l provisions o/laws and ordinanr.es povcm�nr�this I�ne of wnrk wfll be complefep <br /> H�hethei speG(red herprn or not, Tho pmntrnp o1 n pumnt does nef presume 7a give outhonry fo <br /> viufatu or cancel Ihe provisions o(any olher state or locol law regulotinp construCfiOn Or fhe <br /> perfomiance ol consirvclion. 7haf!am nuthonzed by�hc ownor o!thls propeRy to perlomr tha <br /> work ler k�hlcH applicetion is mado and!comply wifh 1ho Sfate Confractors Law 18.27 RCW�nA <br /> 296.2 WAC. <br /> F�� �� � <br /> ignalurC U3IC <br /> Pl��se c��.�e 4Zs- 9� ) -a5y� �Y�,en�-� � . <br /> � , <br />