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RUG-2-2011 10:58A FF.OM�RCCURPTE HERTING 2069370777 T0�1425257B857 P•3 <br />i� i <br />ELECTRI�AL PERMIT APPLI�ATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.evereftwa.org � `Z `� { <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �' /D � cn � <br />V <br />�12Z Noyf Ave �Ever�i�' � Wl� 9�zO1 <br />PROJECT ADDRESS <br />Tenant <br />Eledrical <br />"j Z. Z <br />Maii Aaamss <br />5 c� VY1 e _ <br />Mail Addrtass <br />�GI� swRoX 4y�. <br />F„�E Elec#r�cal LLc e,�-i' <br />Moil Addroes <br />(�ccu2NE qS� NN <br />Stale Licenso Number <br />�Ir�ma resir�ene <br />Proposed U oi Bulding — <br />Oescription of Work in , one: C� 1.J 1 Pe. e?Ci $'t � n <br />NOTE: EIRIN RACEWAYS MEC OR ACICAB EUIRED TO <br />CIT! OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />ary <br />�ily <br />Gt/A `ibz.ol 4zs zs�-�`' <br />siai�rziv Phono <br />StelelLp <br />wA 91��0(� w� y <br />Phono <br />-o� - <br />Cily StalolZip Phone <br />���� �, �,D <br />Cantred Priee o( Wotk <br />j�a�i- ��ownl 2S3 q73 - Il� �{° <br />— Contact Person (Plan Revlew) <br />FEE <br />( .�� 0� -���o <br />v <br />