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03/26/2008 08:11 4254885288 PAGE 01/01 <br /> � ......._ . .._... .._.. . ... ....� ��.. ..�� ....�� � � ui - <br /> �_— ( <br /> ELECTRICAL PERMIT APPLICATION <br /> C17Y OF EVERETT PERMIT SERVICES <br /> 3200 CEDAFt STREET, EVERE7T', WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.eve�attwa.org <br /> APPI.ICATIONS ARE ACCLPTED FR�M 8 AM TO 4 PM -DE6R& CRHDIT CARDS ARE NOT ACCEPTEp <br /> �So� w P�e���--� RD (6�� �o - os� <br /> PRWEC7 AI]ORESS �� <br /> Ownor �� M9IIMEress Ciry Sc11A/ZID Fhone <br /> �t3�cOG- Y� -os� (�5� <br /> �►qESS�eR - Dow� q-so� w Vaz����x RD gvr�oxx�r wh- �StoS g�3 <br /> TP�3i1� Ma�l Acfdrese <br /> � CitY Stata/C�P Phone <br /> �i p.� vac.es 1B2y� N �1� �"�w�WA �953) 3�� <br /> KW <br /> EleCtriC31 CO�traeWC MailAddrecS pi4y SqW?1p 7hOno <br /> (��►SESr032og y-25•04�.a 2aoa <br /> SF9tc Llcense Num�ar ���P��We* <br /> Qog Qox as3-3}�-���� <br /> PraposarJ Usa of Builtlinp Contact Per.�n (Plan Reviow) <br /> Descrip6on of Work to Ba 0oao: I�1R►�— CLY J GhrK.py�,: �q�1A,` _ � <br /> ------- n�a ,.<•u-� <br /> NO7E: WIRIN6 IN fVON-DWEI.LINGS IS RHQUIRED 70 FEE <br /> 8E iN RACEWAYS, MC oR AC CABLE. <br /> �J <br /> CITY oF EVEit677 I.00AL SALE9 TAX COOE 19 3405 � <br /> !hn�ub ccrtify fhai 1 l7ave r9sC or14 axpmined th/s ap Ocetion arr0 know the sams(o bo tnre anC <br /> con•ectY N!provlolona oi laws and wdinancea yp�rs�np Mls�pn a/wurk wilt he oomp/eled U tl 3 =I _� 4� <br /> w17BthBf speciRed he/fih O�npT, The pI8rIN�A o�e perm�f do� not ,esume ro gWo auth�ri(y fo � � <br /> vipl6"o oI cancel the DroY19/o/f�^._n/any other�tete orloeallaw abn �cW7ifNcUw!or e <br /> poKorma»ce ol consPruoNon. Thnt I nm autlrori2ed by the awn� p/}hl�p�pp�r{y to fh! <br /> wor!<fo�whfc�eppllcetlon Is�ftedc eqU 1 o0?lply wiHr the Stafp pntracrors 6aw?B�n2ql��M and ' <br /> 236.?.00 WAC. . <br /> 3-a� -o�' <br /> si�nature , '��q <br /> t� . <br />