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JUL-06-2011 09:00 From:LNP 8886159679 To:14252578857 Pa9e:1�2 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> Io� lo Eucrar c,'�� Euere�� t�f� �`'� <br /> PROJECT ADDR S <br /> Owner Maii Address Giry Statelrp Phone <br /> Cei, o o �u z � S_ L.�A 98�'� H33-353-5'I6'/ <br /> Tenanl MailAddres Ciiy Stale/Zip Phone <br /> Me.�ro C—�/e��-r�i L(L �d33 1°�'Avr, 5. �/05 Sce�'� GJR I`�13`� a53-3G�/h`.`�5 <br /> Electdcal Cont�actor Mail Address Ciiy StatefLip Phone <br /> A/lf_ �!?6FLgf610i�' �'? �5 .. �'i0 <br /> Stele License Numher Contract Price ot WorY, <br /> nnob�k N�� Sa� Sos�. 5�.�..,.,,,�r� <br /> F'roposed Use of Building Conlacl Pe�son (Plan Review) <br /> I Description of Work ta Be Done: LL`rV�� 4 l�a �f a5Y C'�Yl�� f L,I�O�� Lom,�v�U.n' �� <br /> I�r.JtS— ! fo7�cQ' <br /> NOTE: EIRN RA EWAYS MEC OR ACICAB EUIRED 1O FEE r7 O � , / <br /> ,� T- `f <br /> �o(a� <br /> Cliv OF EVERETT�OCAL SALES 7nx CaDE fS 3�05 <br /> l hereby ceRihj that I have read and examined Nls application and know the same ro be trve and �' I �� vn 1 <br /> correct. All provisions of Isws and ordinances governing thie type oI wak wil!be comple(ed d, <br /> wbefher specified herein o�noL TAe granfing o18 permd does nOt�iesume to giv2 authonty lo <br /> viol (e of cancel the provislons ol any othe�state orlocal law regu/atiny consfruetion or the <br /> pe�ormance of constructio That i am authorized by the owner ol thls property to peAorm the <br /> work lof hic applica7ioi� ' made and I comply wifh tAe Stafe Confractors Law 78.2I RGW and <br /> 296.20 <br /> 7- l� -/ <br /> Signature Date <br />