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JRN-20-2011 22:0B From: To:2578657 Pa9e:1�1 <br /> 1 ' <br /> \� <br /> ,, ELECTRICAL PERMIT APPLICATION <br /> :, GITY OF EVERETT PERMIT SERVICES <br /> ,:' 3200 CEDAR STREET, EVERcT7, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> � APPLICl1TION&ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � �.� 5 Cr'a.��Srv� '�l0 � <br /> PROJECT ADDRESS <br /> c <br /> UHOCr 61a11 Address City S�olc2p ���. PhooO <br /> �.sd�.Q.�t�:cL 1�es-�t.urrc� �l�'� a 57-93�� � <br /> 7enant Mail AdOrese cily State2�p pnonu <br /> ���-ol ���►� aa� i ����� ���P�- I� G�?ol ur��k 36�5 <br /> Eleclrical Conhaclo� M11ail Address Clty S�atelZip Phone <br /> S0�1ITP ��'��D7 � 3, 7�� <br /> Stale Lir.r,nsn Numl,er Contraet PricC of Work <br /> �..5�✓'r��' �Qn SY�au�a�' <br /> Proposed Use o(audding Conlacl Person (Plan Rcview) <br /> Descrirtion of WOrk l0 Be Dono: U.)1 AJ Y� I � �3C� 4[.Wll (�"� 5���� <br /> �, � <br /> --- Con�-►''a / � ��P11�G�s� <br /> ., <br /> ,, ,. <br /> NOTE: WIRING IN NON-DWEI.LINGS IS REQUIRED TO FEE �>• • <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> w . <br /> CITY OF EVERETT LOCAL SALES TAX COPE IS J705 EI I D I 'U�� <br /> I hereby certdy Iha11 havg�oad Ar 9 examined fhis appllcofion end kno�v fhe samo to be frue and <br /> r.orrocl. All piovlslons o/low5 vno ordinancos govorninry fhis typo 0(Woik wi�l be complefad ��/' ��� <br /> whofhnr spocNied he�eln or noG The g�anting o/a permd does nof resume fo give authonty fo <br /> violale or canc@l lhe�rovlsions ol any other sfafe or(ocnl Inw repuPfing r.onstrur.fion or the <br /> peKomiance o�cons ruction. Thof I am aulhorizod by ihe ownero!Ihls propedy to peAomr Ih -� 1�� <br /> Ko�k lor��AC uppl;caGon is mado anU I comply witb the Stn�e Contractors Caw 18.27 RC W a $ <br /> z9�` br�r� <br /> I -� 1- 11 0�. . <br /> � � ignaWre �� �� � Dzte . � <br /> ' " �d . ��. <br /> P��. G� 5�� <br /> � !-----�'�=N�.-�e.r,�-.r,�'1''°�r�- -�-�a��___.____ � �J <br />