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SEP-23-2004 05�19R FROM:PROFESSIONAL ELECTRI 360 435 1182 T0:4252578657 P.1 <br /> ( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-6857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _�i� i 5 w ���,. ���-�, p,. <br /> PROJECT ADDRBSS <br /> �/�J- <br /> cS�'� /'7`�'c // L/J'/9 (1J G/E.• /e.,�.•, /'r �r.YnrJ`- �f S�'r�J? 3J�i- S�� z <br /> Owner Mail Addross City Stale/Zlp Phone <br /> Tenant Mall Atldress CUy Slale2lp Phone <br /> 3�� <br /> Pro,Crss,� o / y/� /r � !�/J✓3 :,z �/9 ,�i/ ��.-. LlA 9d'ad / %T✓=G',�i? <br /> Elactrlcal Conlractor hlall Addross Cny SWIx21p Phono <br /> 1�/20F�.��SO 7 7.t'.Q <br /> State License Numher Conlract Price ol Work <br /> _��S�clv�.r� <br /> Proposed Use of Bullding Conlacl Person (Plan Reviaw) <br /> Oescripllon of Work lo Bo Dono: _/QPr�r r ,�,c% � t �� i� 6 c.f.sruc <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> OE IN RACEWAYS, MC OR AC Cl�DIE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � / !7� _Q Q D <br /> I haroby cerilly thaf 1 hqve reed and examined fhls appl7taflon end know fhe seme to be Wo and �v� � <br /> corrocf. All pmvlslons (laws and ordlnances goveming fhls typo ol work w111 bo camplefed <br /> whethar speclpod horePn ornot. The gronfing o!e pemuf doos not resume fo glve eufhorlty fo <br /> violato or concol Gie prpvlslons o/any ofhor s(afo or local law reguPUng constructlon or Uio <br /> wo�k�or�vh ch onpllc�on�fs mah ot ond I co�mplyedfd flio State ConfracforsPLawy1B.27 RCW anJ <br /> 296.200 WAC. <br /> GfG/,..�i .✓S /�t�-�*2�--. S= /s - .1Pc> d" <br /> Slpnaturo Dala <br />