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07/15/2012 :0 �.30 =0430 P. 001/002 <br /> 1 <br /> EL.ECTRICAL PEI�iVIIT APPLICATION <br /> CITY OF= EVER�TT PERMIT SERVICES • <br /> 3200 CEMR.STREET, EVERETT, WA 98201 <br /> G25-257-88.10 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �/ 7// U/- ��t�,`iav� �r <br /> PROJECT ADDRESS _. . . <br /> . . <br /> �ass � %�roio�r� ���� LI7// Gf��Ih�GwtQ,- -�v�� 9��3 �LS-23z-.Z6�f <br /> Owner Mail Address ' Ciry StalalZip Phone <br /> ____ . __ <br /> Tenant h1a11 Address City SWto2�p Phone <br /> �-�,l��Y SR irs � �n� 3�o� ��.��.,.��` �;�8r.:b�- v.z.r-Zs�-Zr� <br /> _ ... __ .. . <br /> Electrical ConVactot Mail Aadress Gry� State,Zp one <br /> ��L.9/lISeSIyzL� �� V '.. • �. . '. � ....� �VO�� <br /> State License Numhor � Z � • • �� � � Contract Price of Work <br /> Propos�Use of Building , l ,Contact Porson (Pian Review) <br /> Description of Work to Ba Done: �'��`✓-"�� d j/ J � �k 5 �`�`"A�'`� <br /> � <br /> . .. I <br /> , , <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F�E <br /> BE IN RACEWAYS, MC OR AC.¢ABLE.-� <br /> 5ti - <br /> CITY OF EVERE7T LOCAL SALES TAX COD�.I$.�7,0.5 . ..=: ; =-c e`�;' - <br /> 1 hereby certify that 1 hpve read nnd examinod�thls epplicafkn and know fhe same to be troe and �, I,Zd� - ��� <br /> correct. All provisions oJlaws and orciinancss govemin9 this Iype ol work will be canplefed <br /> �vhethe�specilied hereln or noL Tho prantlnp oCa pormlt does notProsumo to glve authadry to <br /> violAteorcancellhe provislorlsofanyofhorstato_orlocallawrogPadngconsfrucGonorthe ' <br /> performance of construcfion. Thaf I am aufhorized by tlio ownorof this proporty ro parform tha:• � ' <br /> work Ior u�hich appUcahoq!s mado ond I eomply w�th tho Stnto Contrae(ors Law�8.27 RCW and '• <br /> 296.200 WAC. , <br /> ' • <br /> �� G�Z%� - _. __. ?`���� z <br /> s�fln3wre oate <br />