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O1/24/2012 TU¢ L1: 01 FAX 2067676880 61aCk Dox NetWork �001/001 <br /> / '� <br /> ELECTRI�AL PERMIT APPLICi4TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881D - FAX425-257-8857—v�nvw.everettwa.org �—�"�Zp <br /> ApPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM E 12O � "O O � <br /> ��j�i�l Sf. `r_�J���T /�'Ii�LC.. �,t;A`{ � �i�a��'g <br /> PROJECTADDRESS <br /> p�l_U���LR�l14R�=1T ��UNIDN �15�oU S4,4ti�L� w�i"��181� � <br /> Owne� MnllAtltlress � Clly Stalol Ip Phono <br /> C„?GC� <br /> �•Rz �,�t��1421C1�IV.INSu/t/�tiIC4. IDbO S`� �Uf�rTl �4$l(, lv/r� `�Ir�?w 1 l.+Jf� ��0��� 4N�,°—U��'o <br /> Tenenl MallAddress Clry Stale� Phano <br /> (�6�.C_ T'r.L4.�HCN�. cl��c�, �•�G� <br /> 4':u1C'L ��aX N,��.��,R-� 5vc5 k�c Sw 3°I'�S'T �1A RE�tvt�l�l ��n���8b�� ���3-9'i91 <br /> Elecl�icalContracto� MellAddross Clry Stale2lp Phono <br /> u�I�l ��� 5`1� 3�� `I�Sac�C� <br /> State License Number Contract Price c(Work <br /> cF,���m�u-�,�.��� N /q <br /> Proposed Use of Building Conlacl Person (Plan Review) <br /> Description of Work to Be Done: C�k�n!\ .eC�-1'.ff�,t.9�i� (�( �7 ( ��� ��[.r\ h�', � r .7!6Ch..�b1•✓� <br /> • � �—! <br /> '`�3'(,� Y 'I ' S .� Q �1 .11iLG . ,.�G� "'�14 , <br /> ( Lu�� �/U�T�1 G c; <br /> NOTE: WIRING�N NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR A.0 CABLE. �r �/, /n <br /> b w ' �V/ <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS a105 <br /> I hereby certi(y thof 1 have matl and examinod fhis applicoffon ond know fho samo(o be truo ond � I �� I — �� <br /> conecL All provisions ollaws and ordinances govoming this type ol work v�il!bo_comp/olecl <br /> whefho�spocifiod horein ornoL The gmnting o!a permit does nol presume(o give aufhority to <br /> � violale or cancel the provisions ol any ofher sfato or local lew regulatrng cons(ruclion or Ihe <br /> pedormance oI cons(ruclio.��. Thaf I am aufhorizod by the ownerol this proporfy lo pedorm the <br /> work lo�which applicalion is rnade and 1 comply wifh the State Contracrors Law 18.27 RCW and <br /> 296.200 WAC. <br /> , . <br /> - ���,.r�„�.Y� � - -- �- aN-ia <br /> �,. ie�,un�re osie <br /> /' <br />