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DEC-2F-2011 20:37 From: 7o:z578057 Paee:i�i <br />� i <br />ELECTRICAL PERMIT APPLICATION <br />ICES <br />C�TY OF EVER�TT PERMIT SERV �a�a9 -�� <br />320U CEDAR STREE7, EVERETT, WA 98201 �///Z '6 � <br />425-257-8810 - FAX A25-257-8857 — www.everettwa.org �. <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />� �► 30 ���r _e�n G� � �r I 3� <br />PROJECT ADDRESS <br />Jwner <br />C� <br />Tenant <br />Mall Address <br />r.P.�-r� L, <br />Mail Adtlress <br />Elecirir,al Contf3ctor Mail Addrosa <br />�0➢UITP ��'��D7 <br />Stato License Number <br />C�SSY�x�tn b �csz <br />Pronosetl Use uf Building <br />Dcscription ot Work lo B.� Done: <br />NOTE: WIRING IN NON-DWE�IINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCA� SA�ES TAX CODE IS 3105 <br />c��y <br />SlalelZip 25 Phane <br />��$-�go� <br />StalelZip <br />Slale/Zlp <br />� ` 1 9z0 <br />ConUac�of Wark <br />�Q n h?��%�� <br />Contact Person (Plan Revlew) <br />reed and examined lhis 3pp�itstion and know fhe same to be tn�e and <br />�ws and ordinances governmg this fype ol work wifl 6e compleied <br />r nat The r�r.mtinp o( a pennif does nof presume to give auMonry to <br />tions o( any ofher state orlocal law reguleting construcGon or (he <br />in. That 1 am nuthonzed by the owner o/ thls propeny to peAorm fne <br />,� ..,,,,r,. .,.,,� i,-.,,.,,,r� wrrh tnr, Stete Contractors Lew 18.27 RCW end <br />�� o�`� 4����� ) �d5y� <br />_� �i-tn �,r�,�. c��' _ �c <br />FEE <br />�l/ � <br />Phono <br />Pl�onc <br />� I l I Z-�l le'� <br />