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:i� 1. 26. 2012 2: 33PM No. 31i�E F. 2 <br /> ELEC�RICAL PERM�T APPLICATION <br /> CITY OF EVERETT PERMiT SERVICES <br /> 3200 CEDAR S7REET, EVERETT, WA 98201 7 -a 6-�z <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org L���p 7�� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5001 �er�rc�/� I��c Y <br /> PROJECT ADDRESS '� <br /> i �G�Ck��-Oh 5 �4�'� ��ofnrt� rc�� � C�' nler;��c �, ���35 yd j��} �i�t-6�.� I <br /> Owne�� Mail Address Gity Stale/Zip Phone <br /> � � '� � �.'W\ �L��/ 1 t�{�i^},l s�.::9(.5� <br /> I%�C�`'i:Y�' •'`r lid� SCn� ri✓@/�Y1�FY1 lUt�y t,s1 :a�{ _ <br /> --� <br /> nant MailAdd� L'ity Slate2ip Phone <br /> L��� �ri�4�list' � /�,��r, Z'D ��%I�t �6�) 3ys����°Ea <br /> Elecllical Contfaclor Mail Address City S�ate/Zip Phone <br /> X P,SC._�>L.'��jCT;i(� ��1� <br /> Stale Lic nse Number Contract Price of Work <br /> S J�' 1•' 1� l.Nr;':it•i'1 �I,v+:%��� <br /> Proposed Use of Building Conlad Person (Plan Review) <br /> Y�'. r <br /> Descriplion of Work to 6o Done: l���'}� 1'(••� i'.F�C� z'�'ir��a L t���i•� ; N r.�rt�:,r� + Y'1 <br /> � J <br /> t�/1�('. �„�f1 t�,� � �'IT�}i'• ( N '' � ?' "��t� f � j� ��.r�{,� 'sti.,r.��(�^C'`A <br /> ��� � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �D Ol7 <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 �f <br /> 1 hereby certi(y that 1 have read and examined fhis applicallon and know the same to be true and � � 2 v ./- — I � � <br /> correct All pmvisions o/laws and ordinances goveming fhis type of tvork will be completed � ( <br /> vihethe�speci(ed herein or not. The granting of a peomf does notprasuma to give authonty to <br /> violate orcancel the provisions o/any otherstata orlocal latvregulating constructinn orthe <br /> perloRnance afconstmclion. That 1 sm authonzed 6y the owner o/this propedy to perfomi the <br /> work(or�vhich app�ication Is made ond 1 compty wifh tbe Sfa(e Contrectors Lew 1E.27 RCW and <br /> 296.200 WfI C. <br /> � � ��di41�� <br /> Signature Oale <br />