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Feb-02-10 03 : 55P � . P . O1 �I <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE�T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-2;i7-8857 —www,everettwa.org <br /> I APPLICATIONS ARE ACCE PTED FROM 8 AM TO 4 PM <br /> �y�� �-���,�,�- ,� ��,� <br /> PROJECT ADDRESS T� y�f <br /> -�S � <br /> C�p �/�c. i� caM� s��2�rc,�r /9/�! ��/�v __ �.�a1 �/o � <br /> On�ner Mall AAdresy Clty Statc�IC Phona <br /> T�Iwnl T Ida�lAdUress .•....'-- CdY � Stato�2ip ('2� V+hunr <br /> �l'�•��v v�ti sxS 3�.,�',.!!. �!/ , s'�o,_ 1d"'�'j ?�l1_ <br /> Eloctrir,alCUNracWr A1oilAddress Clly gtrte2iD fhonc <br /> E1'�.��v s.s� v Z[ P � ao � <br /> S�ale License Numbor Gonlratl Prir.o ot Wotk � <br /> C��� <br /> Propo;oA Uso of uilding � �'� Con�ac(PCrsun �Pl.�n Reniew) <br /> r � <br /> r <br /> Ooscription u(Work to 8q poner- �h <br /> . _�.[r Lo�'1_ c �T,�.s� c <<r��_.. ---._ <br /> NOTE: WIRING IN NON•DWELLINGS IS REQUIRED 70 FC� - <br /> 9E IN RACEWAYS, A1C OR AC CA�LE. � a SQ <br /> �_ <br /> CITY OF EV[RETT LOCAL SALES TAX CO�E IS 3105 " <br /> 1 hereby te�lily fhnf I have rEed end ex�minoA fhis OppllraGon anA Fnow flie samo b 6o Uue unA <br /> correcl. �II pruvislons ol laws end ordinnnces,qo�•e�runy p�is type�o'work n�116o comp/eeed <br /> �rhotharspeGfied herein ornoG TLe pranbnp al a pp�nuf Aves nof�rosumg to qlve Qufhonry to <br /> wolefn ur c�ncollho provlsiens o!any othe� stete orlocnllaw�epu/t tlnp consfruction or fhe <br /> peilc�rna�roe alccnstruCGon Thot f�m authorizetl by fhe ownor ol�lrls prePaAy fo podonn lhe <br /> workler n�hicb a pOcafion!s rnedr. :�nd I cernply�rifh Oie Sfnto CnnhbcWfs Low 18 27 RCtY and <br /> 296.2001YAC .� <br /> L.� � � <br /> .� <br /> �ipnoture Uate� '— <br /> E 10�,�-0 [� <br />