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Jan. 12. 2010 3: 21PM Liqht Doctor No. 6444 P. 1 <br /> (� I <br /> k 1 •S�b\ <br /> � ELECTRICAI. PERMiT APPLICATION � <br /> � CITY OF EVERETT PERMIT S�RVICES <br /> 320o CEDAR STREET, EVERETT, WA 98201 � <br /> 425-257-Q810 - FAXA25•257-8857—www.everettv�a,orc� <br /> . APPLIGATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ 1D�� Fveu�r�e-e.J� VJc�s., ��iL �•�- <br /> PROJECT ADDRES3 <br /> ovmer MailAddree9 ary sinienin Pho08 <br /> . ���o C�vt�c�rser. �.xu� y� <br /> 24v.n 2c�-�a � ���n � Q, t�('.�.��Lc� Cvt��-4- ►��A qx�� <br /> Tenant MallAddress city Slate/zip Phone <br /> qz5 <br /> UGWr ��nr ( 1 C. 'Z1���.n lnik� '�F., t� �YI(�l�r\GX�'� . �C� 4.. 4551•�1 <br /> Elo Ical Conl�acfor ldallAdd�ass City Slate2lp y' �j Phono <br /> U ��9�q�Lf� Z��b � <br /> Slete Llce�e Numbef Contract Pdce ot Wark � <br /> Co�.�,Mss.ut,�Sl. L <br /> Proposed Use of Bullding Contacl Person (Pien Review <br /> Descripllon of Work to Be Done: L C �( - (, . <br /> NO7E: WIRING IN NON-DWELLINGS IS REQUIRED TO • FEE <br /> BE ItJ RAC�WAYS, MC OR AC CA6LE. <br /> � <br /> CITY OF EVERET'f LOCAL SALE3 TAX CODE 13 3105 <br /> 1 hereb/certiry O�a6 Fheve reod end examined this applicafion and kno�v tha seme fo 6e(rue end <br /> conect. All provisrons ofla�vs and ordinancos gwerNnq thls rype of�vork tvlll be,conrple(ed . <br /> whothersPec/0edhereL�ornoL Theg�en!lnpofeUenmfdoesnot resumologrvaeufhoAtyfo � <br /> Nolo(e orcencol tho provisions ol any othorstafe ar Iocallo�vrt±puPeNng cor.slruclion or tho . <br /> per(onnancQ o/consfruc(lon. ThaN� n euthor/zed b��fhe ownerol fhis rr,peity M per/am the <br /> ta'e�k/or which appllcatlon Is made end l comply with(he State Con:rec�;s Lew 19.27 RCN✓and <br /> 2 .200 WAC. <br /> L / � o ( � <br /> �na(ure Dale � �. <br /> /,n� I <br /> I /V i <br /> . �. ' <br />