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06/28/2011 07:13 3607947362 TNTELECTRIC PAGE 01/01 <br /> C ` <br /> ELECTRICAL PERMIT APPLICATION <br /> C�TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> .��z�f C'drnw�e�����.�.�����- <br /> PROJECT ADDRESS <br /> :�� f�/ Eu°-�'�'{�-- t,��' `I�2b 3 7 <br /> G�.vte 13u.✓�eSS 5'�2�I- C��e% • <br /> p�g� MallAddreee Cdy SIaIWIJp Phona <br /> Tenent MaN nddra•a C�ly SlatelZip Phane <br /> I v�-('�fecf�'���� �� `L�x �ps� �(��e � Y�"27� <br /> Electricel Contrador Mail Atltlreca City StatelZ�o Pha� <br /> Z�fTE L '���I�� Co/4�Z �sno ,� <br /> 5[ete License umber Gantrad Price of WaAc <br /> �Q51 d�.�.�1 aQ (�v�v��- <br /> Proposed Usa of euiiding Contact Person (Plan Review) <br /> Description of Wotk to Be Done� <br /> Q�'��Cc� � C\YU,�-l� t�✓ c�1,lG.T�GSs �I�I�Gc.W�!'� 5�j5� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �O , <br /> CITY OF EVERETT LOCAL 8ALE$T/V(CODE IS�105 <br /> 1 here6y certily fhat I have iead and examinad fhis application and know tha same fo ba hus and <br /> correcC All provisions of/aws and oMinances goveming fhis type of work wifl be complefed <br /> whefher specified herein ornat. The granting o(a permrt dces notP�sume to pive authority to <br /> violate or cancel the provisions of any other sfate orfocallaw repula(mp construction orthe <br /> performance o/construction. That I am eutiiorired by fhe owner ol fhls property to perfoim fhe <br /> work(or which epplicefion is mede and I comply with fhB State ConfroC(ors Lnw 18.27 RCW and <br /> zse.zoo wnc. 3 <br /> �-�b�t �%����� �•7�l� � , � l� <br /> SlqnalulB Date I I O W <br />