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10-25-2012 7 : 35 AM 1a562088664 14252578857 Pg 1/1 <br /> � <br /> I <br /> ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES <br /> 320D CEDAR STREET, EVERETT, WA 98201 � <br /> I 425-257-8810 - FAX 425-257-8857-w'+vw•everettwa.org �� _a5 -�� <br /> APPLICATIONS ARE ACCEPTEb FROM 8 AM TO 4 PM (r./Z��- �b� <br /> ; �-�v�Ey'� I <br /> � ¢/C'Z Ff:,c��� �fl�' • (3t�> 4��7 7� <br /> PROJECT A�ORESS <br /> �� /�..� �.,��J �LC. I zo � . l s`� `�7�' � l�fcs;�"U�,e,w� I.U�} � �idy�3 <br /> 'S �J�'-R�u Phono <br /> Uwner MallAddress Ciry S�ate2lp I <br /> ��xCaV1� <br /> Tenant Mail Address Chy S1etdZip Phone <br /> �iCv� �NTFF_ n✓►Lt �it�:C L.Le aL)4�6uc��*►•'^�`'-}• /r)v�SY'�-n�n'� Wx} r�.�.? 3 <br /> � � <br /> ElacUical Conlnclor Matl Aedroas City Staro2lp ��� ¢Z�P�g�.Z <br /> I �gt. <br /> S v, S' �–c �]��.Q. K� 7 _�nCx� °�i <br /> Slnte License�Numbar Conlracl�Pdca oi Work I <br /> IProposod Uca of Bulldlnp Contact Pcrson (Plan Review) <br /> Squnro Footngo Qf resldenqnl new conslmdion,remodal or addltlon) <br /> � Desaiption ot Work to Bo Done: '`�`'� WJ�!"1J [,/�� /Aj'� iC(c p Ze'�/`� • <br /> / / <br /> � <br /> i I <br /> NOTE: WIRING Ik NON-DWcLLINGS IS REQUIRED TO FEE � ; <br /> BE IN RACEWAYS, MC OR AC CABLE. I ���`.� i <br /> � <br /> CI7Y OF EVERETT LOCAL SALES TAX COOE IS 9105 <br /> I, I hereby cenity thn,t I havo rnod and examined this epplicetion and know fho some ro 6e trvo nnd � �� l� ,_, I � f <br /> cor�ct. All provis�ons o/Jxws end o�dinpncos poveminq this typa olwnrk will he cnmplaforl � I <br /> ; �vhether specl�ad here�n or noG Tho granung o/a pennu d�es not presume to grvx authonty fo <br /> v�olafn or cancol fhe Provlslons of ony ofhar state or foca�law rogufating tonsVucticn or fhe <br /> poAomtance ol onstruction. Thaf I am aethonzutl by:ho ou�ner o/fhis A�PAKy fo per�orm fhe <br /> work to�v bic . pAcat7on Ic mnde ond I compty wiUr rhe Sfate Canlrectors Latv 18.27 RCW end <br /> 2�J6.20 A . <br /> I <br /> /� /D �'4' i 2— <br /> i�• � <br /> .gnaWre� � e I <br />