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10/15/2009 10:6E 4253778977 EOSCH ELECI'RIC I1�7C P:GE 6S/62 <br />E�ECTRICAL PERMIT A�PLICATION <br />CITY OF EVER�TT PEFcMIT SERVICES ,,_ <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FqX 425-25 �-8857 — w�wv.everettwa.crg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO > Ph1 - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />SII Lit-�dev� <br />PROJECTl�DDRESS <br />—��-_ a`7 i� ��TM S�- _'�Je r�,-�� L�- S8'Z O I`� t S. 3 0 3. I I Z � <br />Owner h1ail Address — <br />City S;ata�ZiP Phone <br />Tenant <br />�' SG� ete <br />ElecMcal Contrac:or <br />Mall AGtlress <br />L � $� <br />Mail AAdre;s <br />DS� �-1-ELR �i 3 Q T' <br />Stale Licenco Number <br />�F�_ <br />f'roposed Use of Building <br />Descriptlon af Work to OC Done: <br />NOT�: WIRING IN NON DWELLINGS IS REn_UIR[D TO <br />BE W RACEWAYS, MG OR AC C,�BLE. <br />CIIY Op pVER[TT LOCAI Sqt,GS TAX CODE IS 31a5 <br />City <br />Cily <br />WtR-tNC <br />State2ip <br />�-. 9g <br />Slate2ip <br />Contrad Price of Work <br />Coniatt Porson (PI2n Reviow) <br />1 hereby caRitv that / have read .;nd Pxomined thls applicstron and kncw fhe snmo te be truo antl <br />ccirect Aa prov/s:cns of la�vs dnd or�inances goveminr� this type ol werk wil! be c,mplated <br />e�hefherspeciTed heiein or not 7he �ran1/n9 0/ a permrt does nof presume to glvo authonty ro <br />�iol�tc c� cuncel the prowslons a; nny athor stafe urloCal iaw icgulafing cons7uchon or rhe <br />purto�rnance o! construc6on. Thaf ! am au(he; ized by rhe awnar of fhrs pmperty to pe.ro�m the <br />�vcvk !c� wnich apFliceuc� ;s �naor and I camply wilh 1he Stnle Ccntrac;ws Law 18, 27 kCN 2nd <br />25ti.200 WAC. <br />Phono <br />Phone <br />FEE �I <br />� <br />I <br />'�i�U��� <br />