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1U;11/2�12 16:48 1425?751960 ACTIVE ENGINEERIIJG FAGF F1/01 <br /> I <br /> �LECTRICAL PERMIT APPLICATION <br /> ! CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 99201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM Q AM TO 4 PM � <br /> I - �'�JO� �Olv��cC� AV- <br /> I PROJECT ADDRESS <br /> C� �� 3on8 �,oMllrra A.ir- �vtrc.-N- klr� 9fr?vl 425�52�3}55 <br /> a <br /> Owne� �dailAtldfese City Stalc/71p Phonc <br /> � �. ,�S 3 boJt. <br /> Tenant MallAddress Cily State/Zip Phonc <br /> �C.�i�t �.� ,.i.c�..c Ll�US Zoo� Sl SW L��hnwm.� U.S(k r72�3�0 4LS•�}4 51fS <br /> ElBctrieal CoNraclo�— n1ai1 Address City State/Zlp Phone <br /> � <br /> �c.1-t�C '� O g5 1�S ISD Go <br /> St21e License Number Contraa Price of Work <br /> ��,�P_ <br /> � Proposed Use of 6uiltling Contact Perso❑ (Plan Review) <br /> Spuare Faotage (I(fesidential new construction, mmodel or atldition) <br /> DCscriplion of WOrk to Be Done: �prono-..� � YC�oi�V.t'�' '�f hdCf� <br />.� <br /> NOTE: WIRING IN NON-OWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA6LE. <br /> ; � <br /> � CITY OF EVERETT LOCAL SALES TAX COD6 IS 3105 <br /> 1 hEreby certi7y thaf I h3ve iead and examined fhrs appliC�(ion and know(he 5ame to be tNe 3nd ��/"� I D _ (`j�" <br /> CofYeCt All prCviSioroS ollaws and oN'rnances governing Ihis typa of wodt wilf be comp/eted UC �Q <br /> I whetherspscilied hefCin o�col. Tlte Or3ntm9 oia p9rR7d tloes not pra5ume f0 Oive auNlonfy t0 <br /> violafe orcance/thz provisinns elany o[he�stafe or local7aro regula6ng cons(ruction or fhe <br /> Iper9omrance of censfruction. Thst 1 am aufhor¢ed by the o�t�nerclfhis ANPerty to pedorm the <br /> v�ork lo�tvhicn spplrcabon;s ms�e and 1 comply wi�a the Sta7e Contracrors La�v 18.27 RGw and <br /> 296200 Vl'AC. <br /> ll�'� � i1�.n� 1 bI l l I I�- <br /> SignnNle D�te <br /> — _ ——„.rt: <br />