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Jan-28-10 12:72P <br />ELECTRICAL PE:RMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEI', EVERETT, WA 98201 <br />425-257-8810 - FAX 425-757-8857 — v✓ww,everettwa.org <br />APPLICATIONS AfiE ACCE:PTEp FROM 8 AM TO 4 PM <br />3 I � o ��{��n ._ <br />PROJECT qDDRESS <br />y1s <br />P.O1 <br />1 �.�'tnANtL.._.��'�o( `� `�-�Sl� <br />�� � ' . ��.� 3/� <br />Ownor htYil AddreSs Cdy Slatu/Zip � Fhono <br />T8fIJ0� <br />Idail Address <br />Ci1y <br />titJlC2ip <br />Phonr� <br />lzY . ti/�e:�. S�s 34�� f-� �v _ �G �sq �/�_. <br />Elnr.�ric.d Cnnlractor hten Aadrelti � t:ily Statrn,ip pnp�P <br />fz��,�Nrs/yz U� <br />Slaln I icenso Numbcr � Contr�r.t Pr�ce o1 Wurk <br />K �� N 1 Sf� <br />AropoSed Uso of Buildiny Cuntac� Pervon (Plan Reviow) <br />DCScripti0n of Wu�k lu Bn Dunv. <br />,h�<il�(�..-- '-- <br />.� /��}7Nn��lr1 �n [.ir��i11A���.. <br />NOTE WIRING IN NOtv•DWELLINGS IS REQUIRED TO <br />OE IN RACEVVAYS, MC OR AC CA6LG. <br />CITY OF EVERETT I.00AL SALES TAX COtlE IS 3105 <br />! f�eruby certily (h3f f hnve re�d anJ ex; <br />conoct A/l proNSfons o/ la�}:5 nnd ordii <br />whofher spnciGoU horarn or rroG Thc �: <br />viokrte or cancel the �rov�sions u( any t <br />poriom�e,nca olr.ons�rucfion. Tha! 1 an� <br />work !ur �shich applicet;nn is mado anc <br />296200 lS�AC. <br />l�qire._ _.._.. .._. <br />thrs apNlication ami hnun� the sema fo be trua and <br />govenang tfds f�-po of wnr� wlll be cernUfafod <br />�( n pertnd dnes notp i esim�o fo yive auibvnty f0 <br />ite erlocef lew rapu/aling cvnsfrucfion or the <br />iy �rnn u�e araro l,ofllreCfOrS La�r 1 b,27 RCW and <br />. % '�' _ Q �— <br />U C <br />FEF � <br />�S �� <br />' ��( -� �U <br />