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10/O1/2010 PRI 13:16 PAX <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-SII10 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />j'..: t� �r�:�., �.�.. j)";L;.11 �,..,���.:;. <br />PROJECT ADDRESS <br />i(tl.,.C�4;•., � I l�:i ,; � C,r; r;. 6� ;`: j-i;.; (�(:� <br />Owner ' Mail Atltlress <br />�� � - <br />n.: �- jr/ . I��7 �:.V iJ' t..�i-� <br />�iiu��Ti i � �c �(��r ���.( �1 � r; <br />Tenanl � Mall Addwss <br />r � r <br />�Il���I �i(�ji '�� ��(i.�.��1 ,�L;l� 1�.. L;`.�';. � i,, <br />EleUrical Contraclor Mail Address <br />1��!. L .l C '�'V `}'�)r.�.ilil�i <br />Stale License. Number <br />Proposed Use of �uilding <br />�� 4 <br />Ci�y <br />� <br />�ooz/ooz <br />\ <br />� ��ti.•�;)i ��.:)(�1,;�.c�5 <br />Slale/Zip Phone <br />1ic:if V�c.. i.uccert t'>lsc��t�ir� `�` <br />Cily SlatelZip Phone <br />� . �� . �. <br />� , I � l' ' lt � <br />I I<:t � � ri ; �, il lo(.' J-f �, �i., : i>;`:i � <br />� City SlatelZip Phone <br />q'-� f.�� �,'�% .j) �SG• <br />CnMracl Price of Work <br />�-'. r i F�. ��f'( V J:)•..1 <br />ConlaCt Person (Plan Review) <br />Descriplion of Work �0 13e Done: F�i l. \I 1(�. ��r'' 1(�1��'.;�I1-LI � � i`��',��� �J f;� � l. �• i�..l �:1..�( L.1 i I- �I <br />/ �, <br />/\Il��'' \•`•(•� l� (.�%�..��(-1I���''��,<�j <br />NOTE: WIRING IN NON•DWELLINGS IS REQUIRED TO <br />DE IN RACEWAYS, MC OR AC CABL[ . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I herehy certily fhat I have read and oxamined Ihis applicalion and kno�v Ihe <br />�.....,�r nu on,��c�nne nf �mv.c and ordinanr.es navominn fhis fvae ol work v� <br />--- --- �t; � � ( � ,�;' . � ��. ;�'�. l-` ._. ;1:�� r <br />. ;�Signawrc . �--� . Dato <br />FEE <br />;: fo be true and <br />� complolod <br />'ve oulhonly lo <br />:lion or (ho <br />(o peAorm Ihe <br />78.27 RCW and <br />E(Dl6• �JI �. <br />I.I <br />� <br />� <br />