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Dec-20-11 1Oc11A <br />ELECTRICA� FE'RMIT APPLICATION <br />CITY OF EVERETT I�ERMIT S�RVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX A25-257-8857 — www.everettwa.org <br />APPLICA710NS ARE ACCEf�TE� FROM 8 AM TO 4 PM <br />�-� � 3 �-���,.�� �o ._ <br />PROJECT ADDRESS <br />YLS <br />-�3� <br />P.O1 <br />�Q /,� !j � <br />lY.Y�,�.._�5�.�(.'_•---.-.-.l11'�.� ��7'�l�%7}�_ �ii% � /�'�D�....._....../�__--- <br />O�vnof M11all Addross Ciry Statu2lp Phonc <br />Yo 17 �--� we. __�Sl�--- . . _ _ _--- ---- --- <br />Tananl n�e�lAJdress (:ay 5latelZiO �fRone <br />C � �! ' <br />�i'��r,�"� 1"� f 34�� ���_ _ � _ �' �y <br />Elec�riCal Contr2c�ur P:1ailAddress City SleiclZlF� N�����'" <br />�(L�.,V s'.l /}'.'L Lp <br />Sla�o Licensa Num6cr <br />J �� <br />Propused U;e o( Huilding <br />Desr,r�ption ot work �o Cie DonN, __1uCGt'_irY� oV[_ti����-� N <br />02 � �Lc�t� �— ------- _.-------- . .. --- <br />NOTE: \NIRING IN NON•DWELLINGS IS RE�UIRED TO <br />BE IN I�ACEWAYS, MC OR AC CABLE. <br />CITY OF EV[RGTT LOCAL SAL[5 TN( CODE IS 3105 <br />Goos�t W( i1� �e f�C�f' <br />C;qntrect Pricg pf Work <br />Cont2cl Persun (Pl:m Review) <br />1 heroby r,ortity that f hav�� iead and exarnined lhis al�P'��AII011 211(I Y.f10W IIIB SBl17B (G L�6 Illltl U!I(I <br />conect. All Provisions of la�rs 2nd orAinances govornlnp i1�is lype cl wak will Ue cornplete.d <br />whethrr spectlicA horoin or nof. Tha g�anting Of a po^nrt AoUS ��ot ��esume fo t�ive authoiity Io <br />vrolafa er cance! �he prov7sions u! any ofher stefe or locol 7air repul din,q consWcfion or fhci <br />peAormance o/ construchon. Thaf ! arn QuthorizeQ Uy Ihe ownei of thls propeRy lo pedemr Ihe <br />work far which a ph i6or7 is madi� And ! conlply �ti'ifh the Sfete Con'�acfois La�v 78.27 RCW end <br />29G Z00 4VAC�� � . <br />�"�/i� ��DaW� <br />1=CE <br />5� � <br />� I � 12-�2� <br />