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From: 17 /�2/2010 08:38 n2o4 P.001 /001 <br /> ELEGTRICAL P'ERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVI�ES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-881 U - FAX 425-257-8857—www.everetttiva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> la o� s� �-, ��,-�� �� r���_.�c � ��,y <br /> PROJECT ADDRESS <br /> IOwner Mail naareas clry State2ip phone <br /> ��GLv`1�oo ��L���nti o�loDl �`�'��VL '� ��J� o�C�C�-�4�. l � � �5 �d'`�Sl/ <br /> Ten3nt IAddress City S(ale2lp Phone <br /> � <br /> \ o�� ���71 �^ , c� SJ <br /> ��,�2Z. 1�i1.� � �. (�-lo�( 1 'e n� L )�- �i'�DS� y �-� - `��195" <br /> Elecincal Conlrador Mail Addreas Ciry Slate2lp Phono <br /> ( <br /> C,�..��--r�� ��ic-�� �ve��,���v����v� �7Z°° c�Iv�. �1 �lv�.�o-�, <br /> State License Number -� � Contract Prite ot Work <br /> c r1 �� <br /> ��nni :.�-i�- r)1�e5�- �'��-1��1D� `�P_�2./y��'1 <br /> Proposed Use of ding Contact Person (Plan Review) <br /> Description of Work to De Done: 1+ll,SiE3�.� LJ ) /j�\ LS7 �Q���..5 i� ,-,,1 <br /> � � t�l n�, (�� C���C�Q � �d� S , I�� �l ( `� � ��..�Lr2" <br /> OA � <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN R.4CEWAYS, MC OR AC CABLE. <br /> � b , �U <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I horoby certi(y fha�!havo read and oxamined tlris application and know the same to be tnie and <br /> corrocL All provisions oJlaws and ordinances goveming this typo ol�vork will be compleled <br /> �vhsther specilred he�ein or not. The granting o/a pemu!tloes not rosumo fo give authonty fo <br /> violato or cancel the provisions ol any other state or locol law reguP(ing constiuc(ion o�the <br /> pe�formance oI constniclion. Tliaf I am authorized by the owner ol fhis property to poAorm(he <br /> work Ior which np ca �on is made and I crornpty wifh tho Sfafo Con(raclors La�v 7827 RCW and � /� <br /> 9G?}00 WAC. ` �� �a� <br /> __ Signdture •.— - .. Dute � ` Z�� � I O I I / <br />