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07/13/2010 15:32 14257751968 ACTIVE ENGINEERING PAGE 01/01 <br /> \ �. <br /> ELECTRICAL PERMIT AF'PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everetlwa.orn <br /> � - �y -/v <br /> ApPLICAT10N3 ARE ACCEPTED FROM 8 AM TO 4 PM L ,a�.�53 <br /> 1319 Hew;4l p�� <br /> PROJEC7 ADORE55 � <br /> ���,,, ba�Qs t���t � ,�,�1� ���. �,�<<p�.�. v�1�.98 zo� <br /> p�.y�ef Mall Addreas Cily SteM/Lip Phone <br /> Tenant MailAtltlreas CNy SIaro21p Fhcne <br /> ►J�'�` �ad 6kok�c. r �� �o"�S+ 5�.1 I.iw�wood JA 4Yo3L 415•��t-tu1 <br /> Electrieel COhtfetto� Mail Address Clty SlatelZ!p Phane <br /> � � 0.7 <br /> C��v¢, �F'c ���N� S � /'/l"�/�� �'' .�-- <br /> Stnte License Number ' � Cont�act Price of Work <br /> �R � C�'G <br /> Pr���of Buildm ContaU PQrson (Plan Review) <br /> Description of Work to Be Done: � ��� ��q���Y,j�►�� � _ _ <br /> \ <br /> �.e �,�... c�^o��A.`d.� � (�>�c C���� mC <br /> Al�___ 1 �,-;,�'�Sa �� Z <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABIE. — <br /> / PZ� � <br /> CITY OF EVERETT LOCAL SAL�S 7AX CO�E IS 3105 <br /> �hareby certify fhaf I Aeve rted antl examined fhis app�ication and know the seme to be true end <br /> correct. AI!plowsions nilatvs and oMinenCCs goveming fhis(ypo ol wor)t wifl be compfetM ' <br /> whether spec�ted herein ornal. The grsnh'np o/e pem7d dces nat recume to givs authanty to <br /> vio/e�eorcancelthe provisionsofanyofherstateor/xa!lewreguPfinpcvns(ruchono�lhe <br /> perlarmance of construction. rhat 1 am authonzed by fhe ovmer of fhis property top��(prm fha <br /> �wrk for w 'ch a , e entl i k�ifh tfie Sfate Contrac(ors Law l827 RCW Antl <br /> 296.20 C. <br /> i� <br /> / .� <br /> 7 3-!d -� -_ ,- <br /> Signn e Date r- <br /> L- <br />