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FROP1 :Everqreen State Heat u R/� FAX N0. :4252596660 Sep. 22 2009 FJ9:43Rh1 P2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U CEDAR S7REET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPUCATION3 AftE ACCEPTEO FROM 8 AM TO 4 P,N <br /> �Lq�d2 CZ/1/[ 5'%. <br /> PROJECT ACORESS <br /> ✓L-7�y��2 �AY� Y9/� ELrn �_ F-�i, ��v3 LaG- t/�� -3�,z,r <br /> Owner MallAatlr000 Clly Stolol7Jp phone <br /> Tonant MellFddms6 Clly 'Stetelzlp Phone <br /> �'�rzG�,. r. _ ss��x-r.,�7,qs zi zo a�.,,� �c� c��� 9�.�> zs.�-3ir� <br /> ElectdoalContreclor MonAddtt:ci Clry Stato2lp Phona <br /> �=�/�72��5�l,�S .�/v S'�. !ro <br /> St�le Uconso Num6or , Contract P�Ice of Work <br /> il:-�/d�s�,��� ����/�'n- <br /> Propoeed Uca of BulldinB Contact Parson (Plnn Review) <br /> Doscrlptlon ol Work to Do Done: //!�S`%74/_ G �'7'�7l/"GJ/1�� ,>y,$j��� <br /> NOTE; WIRING IN NON-DINELLIN05 I:i REQUIRED TO FkE <br /> BE IN ftACEWAYS, MC OF2 AC CABLE. <br /> CITY OF EVERETT LOCAL aALES TAX COD� IS 3108 <br /> I horoby cortlfy thof I havo road qntl oxomfnod flrfs app/fca(fon end know fhe sumo fo be lrtie snd <br /> corroct. AIl provisions o/ldws and ordinances poveminp fhls typo ol worir wlll6e campletoti . <br /> whe(he�specdmd horoM or not Tho gronf7ng o1e pormrt does not resumo fo glvn aufhonty fo <br /> v/olete or cancel the pro visions ol any o(Irer s(ate or foeol!aw roguPa�ing eonswe(ion or tho <br /> podom�nnco o/consWctlon. Thatlom Bu�honred bylhe ownerolfhis p�opaMy(o pedorm fho <br /> �vork 1or k�hrch epplrcdfion is made dnd I comply wlth tho Stato Conf�r�ctors Law 1B,27 RCW and <br /> 295.20C WAC. <br /> �����- �/z�/o� r`� ,�l <br /> Sipnewre ate �1 U <br /> LI <br />