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iJll26/2i7i3 iG: 37 14�5?�51960 A�TIVE ENuIF:E�RI1Li FAG= ��1%U1 <br /> � • <br /> . ---�---� -- -- — - --- ----_—.-� <br /> � <br /> : ELEC'rRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEf�PJIIT SERVICES <br /> 32�0 CEDAR STRFET, EVERE i f, WA 98201 <br /> 425-257-8810 - FAX 425-?57•Bf357-wvnveverethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO d PM11 <br /> i <br /> I I <br /> I 1 ' <br /> � � � Z � IrUYY,�;ArG� /�JG �`Vc� c..'�� I <br /> i <br /> � PROJECT ADORESS ' <br /> ! IZc�ry �$ohnsc . IiZ3 Lon. �n„Y��Jt ��+.ie,-li' l.��CT 9fi7o� 3Go 3y� s�c2 <br /> Ovmer 61a:1 Pddmss C'ly SIa:c2ip :honc , <br /> � -- <br /> Tenant Modnaerer.� C�ty S:ateZp vhcne I <br /> i <br /> tJ� - � .e�,..c� (�i.fl's Z00� S�- 5�...1 ES�1r.Ot�cl� �,�P 5�L3to �ILS.�-��_���� i <br /> EI_C,riWl Cen,r�e!or r,1a!I AtlOress Cty Stzte2!G Phcne � <br /> (l. �l�v.z �` G Fs�M C� /S c ' I <br /> State Ucen;e Number Conuad Price of�Piodc <br /> ' prCpnsed ll>e of Bwlding Contact Per,on (Plan Reviev+) I <br /> � <br /> Squam Footage(If res!dentlal new constructior, remodel or ndtliuon) I <br /> DC3Cri0llonof6VonttuRvC�ne ... � o�n y,4. � ftConn_{y� 0'�'�yLy_�+'- �I <br /> __ __ i <br /> —__ � _ i <br /> NOTE. WIRI�G IN NON-DWELLINGS IS Rc�UIRF[) 1'O FEE � <br /> �E W RACEWAYS. MC OR AC CABLE . <br /> I 50 0.�_ 1 <br /> CITY OF LV[R[T�T LOCAL SALES TAX CO�E IS 3105 <br /> i I hx��ny cert�(y Naf!havo roatl ond exnmined fh�,opplicotion and know fhe same to be Uue�nd <br /> cor��cf Aif provrs�ons ol/nws and Ort7inOnces gavemin9 fhis type o�wO�N wJ(DO GCmpIC1Cd I <br /> Iwho(nersFoc�(etl hem�n o�not The grdn(m�oI a pd�im(Joos not prasurr,e fo prve nufhor,ty tc � � 2,� I �' f� i <br /> vio1Ale or cancel U�e provisions of any othe�sl�te orlccol lnw m�ulalin�conslroc6on or(hv ,/ J <br /> Fs�!ormanco c�conSWeflon. 7haf/om uuthonzvd by tno an�nor o�lhis proporty to per,brm the I <br /> i �vork lor which oCplrCpfion is mutlr. dnd!romply vnfh;he Stafe ControCfor„Lo�v 78.27 RCbl'and <br /> 296 2C0 WAC. <br /> �� ���� /� <br /> Sipnaiure p��o i <br /> I — — —J <br />