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El?!23/2909 07:J1 42548852B8 FAGE 01/01 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT P�RMIT SERVICES `�3,,o B <br /> 3200 CEpAR STREE7, EVERET7, VVA 98201 � ? <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org ���O�"E�J I <br /> APPLICqT10NS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> &-�� <br /> }5� � W P���-�.. (z� �k4o-os <br /> _- _ _ <br /> PROJECT ADDRE55 <br /> OwnOr Mall Addross Clry SlafeDJp Phonc <br /> 2n� <br /> `�E �2o�P�5'[-E �o � w Qert�.u���--� Ro ��{o-os Evt�cS'r 518 firsz <br /> Tenant MailAdtlres� City StatefLlo Phone <br /> Z S� <br /> � �Gu2r� �x��c.o�i //f3L`/ A%- CREE�cQxw f �4l(bT 8:i71e7-L 4./4� }(JUl/ 3'7-"�-Iff<�� <br /> EleetncalCOntractOr MallAddr>4s City State2lp Phonc <br /> � <br /> �7��Sizly�ZuS ?�oo.oa <br /> State License Number ConUact Pnce of Work <br /> iZC� x 253-3?}-�I�•y <br /> Proposad Use of Builtling Co�taCt Porsan (Plan Review) <br /> DescrlptlonofWorktoeeDono: iNsti°ri.� N � aceC+-- ��-�AS���-�+S Go��to�—� <br /> ttr I.����� (t�P4w�l qW_.-*� Urnl� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEb"JAVS, MC OR AC CABLE. <br /> � CITY OF EVERETi'LOCqL SALES 7AX COPE IS 3�05 // <br /> 1 hereby certAy fhaf I havB ieBd B�d examinetl this appl�cation antl MWw th9 same!o be Uue antl ���� � •` � <br /> conecf. All p%Nsions ot laws end o�dinances govCming th�s type of wotk wfl7�e rnmpleted <br /> whethe�spedl�ed herern o�not. ThC granGng of 9 pemnt does not presume fo givo authonry to <br /> viofateorceoce7thaI�rovisionso/anyofherstafeorlocallawiagu/a6ngconsWctionorthe <br /> parformance of constrocfion Thaf 7 am euthonzed by the ownerof this�roperty to peAorm the <br /> work ivr which applicstlon is made and I cemp/y wifh ti�e Stete CoM2ctors Lsw 18.27 RCw and <br /> 296200 WAC. � <br /> , ��, �-z3-ot I <br /> Stqnaturo Oate i <br /> J i <br /> � � � <br /> • � �—7 _ �/ � <br />