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Nov-30-09 14 - 054 P -01 <br /> ELECTRICAL PEI�MIT APPLICATIC)t� <br /> CITY OF EVERETT F�ERMI�' SERVICES <br /> 320� CEDAR STRCET, CVERETT, WA 98201 �� _�� '��t� <br /> 425-257-E810 - FAX 425-257-&857 —www.everettwa.ory ���� ,�I 7 6 <br /> APPLICATIONS ARE ACCEFTED FROM 8 AM TO 4 PM <br /> 3:��3 �-r,�,/�n�UC ��__ Y�s' <br /> PROJ[CT ADDRESS <br /> 3�3 <br /> �M� l206�i1(J �0223 �✓k�i�!¢�F�/1�"fT �'•�7 � _� <br /> Ownr.r M1tall P.ddre55 C�ty Slalc�Zip Ptione <br /> "......._.._. _'-...._.._"'___ _...'___ �..'_ <br /> Tq02i11 hlall Address Cily Sta1��ILip � F!iGni3 <br /> Zf <br /> �hda�< .��.r ��� �� _�� �'�'� _.�s, zi�� <br /> ElCclrical GOnVaC10r ldall AJdn+ss ���ly Slale2ip Phon< <br /> ��L6f �ut.!> y 2��' ____...._._ <br /> Slato License Idurn6er Conlracl Prir.e ot Work <br /> C��� .._ ....._.- <br /> Prop sed Uso ot Buildin� Conlact Person (Plan Review) <br /> Descriplion of Wo�k�o D9 Dorle: _.__-_---- -`�,`�� � �J� .._.--- ' <br /> --��E1J /116T��- �������$�--- _..� _._..._._ <br /> NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIRED 7C� FEE � <br /> D[ IN FACEWAI'S, h1C OR AC CARI,E. � � V' <br /> IV <br /> t <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 hereby ceni/y fhal f hat�e reaJ nnd eaaminoA tltis aPP���alivn end A:rro�ti'the same(o be truo and ��`� , ' � �� <br /> conact All provisions of la�vs and onfinancos govornrr�g Ilus fypr. of worlc will be compfetr.d <br /> wh�fhe�Specl(rc�d hor�m cr nOL Thc grantinq o(.pPntu(dOes rtol icsumo to plvo�uthori�y to <br /> �•lola(o or cancel fhe provisions of any other seafe erincal law reiterPiiny consfruction or fhe <br /> performance ul conslrucfi��n. That 1 am nidhonzed by tho o�tinor of fhls prupor}y(o poAorm fhe <br /> �ti�ork !nr�vhich 2ppllCefiun is mado nnd!comply wilh Ure Sf��lo Cw�tr ndois La�v 18.27 RCW and <br /> 29E20U WA . <br /> / <br /> ...� �u L� —_ _.. <br /> SiprmWru �' �aU' <br />