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03/12/2013 TUE 11: C9 PA7! �002/003 <br /> i <br /> i <br /> ELIECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425•257-8857 —vnw�.everettwa.org <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br /> U �e l o ��e2ajYZe.e� l��y l,�n;� Z <br /> PROJECTA�DRESS <br /> o�9a�er�- Y 2a�- 3 i� - <br /> B65ec� � 1�G I 1� �.J ��J S� #�{ S�.-t�-e U1� �I `�I I�1 �l�2. <br /> o.vner "" �.+aa nad�ess cny sta�e2�o anone <br /> pood�e 3�q UZS-7�Z— <br /> SPou-+s U �lo EYe�►�n v�o.y #z �v��-: uJAvl�"Zo3 t�o1 <br /> AF E�L'`R-� � � 8 Z5 �S«���S-I- 5.2�.Y-t-I.P W A �1�13�1 �SZhs <br /> Eleclrical Conlractor h�an AAdress Cny Sia�e2ip Phone <br /> �Sy�0��1�°►Z��I �'v1 � I D Oo <br /> Slale Ucense Number CDntract Price of Wark <br /> chu�� o�-� ��� s+�.�� s'Pl,�n M �►�uzi 2f <br /> �v� c -e�u�y�vle�- <br /> Proposed Usc of 6uiiding Contact Person (Plan Review) <br /> � Square Foutage(If resltlenlial new cons�rvclion,romodel or addiUon) <br /> Dascnption of Work to �e Done: ` ` O V l �v� v��V��� ���/ 1� � � <br /> �r�Q�.-�p�4v� � � i�I i> r 20� I � 5 �.- c� v_c�.c.� -t- <br /> -PX�~I�vt S�� d�l -�'v � L� - <br /> NOTF: WIRiNG IN NON-DWEl1MGS IS R[OUIRED TO PEE <br /> 66 1N RACEWAYS,-MC OR AC CA6L[. <br /> � �� �D <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I he�oby certily tha(I hava road and examin�d Ihis�pplitafion nnd know fho samo fo be lrue and <br /> conecl. All provisions ollows and ordinences govermng fhis type of worA wilfGo completed <br /> whetherspeciLed horein or noL The granfing o/a permd does nnt resuma fo givo eu(honty fo � � �3� /� <br /> violafe or cance!fhe provisrons of any othor statc or local law�oguPfinq consWcfron o/tho . V �� <br /> � pe�toimance ol consfnrcfron. Thaf I am auBionzed by lho ownor o!fhis property to peilomr Iho <br /> work lor which applic � is made and I comply vdfh fho Sla�o Contracfors Law 78.27 RCW and <br /> 29'... VAC. <br /> 3 12 13 <br /> SignaWrc Oato <br />