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12/10/2012 MON 7: <br />ELECTRICAL PERMIT APPLICATION <br />CITY UF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-25Z-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />�I�j C��.�� �V2 S'� _ <br />PROJECT ADDRESS <br />�ooiiooi <br />ra-�o��z <br />� /2�Z �yl/ <br />K�N ni��LSON 3�1(3 C�G'A��I�>�I�ESE G�1C-�-C�rT" f�J/a�SZol U2551zoo�)U <br />Owner Mail Atldress Gry Statc2ip Phone <br />\� �� �� � � \\ �/ <br />Tenan� Mail Atldress C�ty Slale2ip P�one <br />�1 S'( U Ll t.i) i S-l-� <br />c�ecr�� � �25 S�fiu cy �� S=ea-t�-f��e vJA �i �131-f Z�u�� �3 "LSzS <br />Electneal Comractor A1ad Address Clry Staie/Zip Plione <br />� S i�(1 l�t ��I�QZSN /VI �tP J��J� <br />Slale License Number CoNract Prico of Work <br />�,5� ��Pvl-h Gt.� �C�n � C�1 aS� �l <br />Proposed Use o( Building . Contar.t Pcrson (Plan Review) <br />Square footage (If residontial now construclion, remotlel or atltlihon) �J ���,�p <br />De;cnplion ol Work lo Bo Done: /`� �" I�✓✓�.- G� I��,� "j� <br />IJOTE: WIRING IN NON-OWELLINGS IS REOUIRED TO <br />f3L IN R/�CEWAYS, MC OR AC C.4BLE. <br />CITY OF C-VFR[TT LOCAL SAL[5 TA%CODE IS 7105 <br />�oad antl aranuned thls applica(ion nnd knowlhn sarne fo bo fruc ond <br />iws antl ordmancos govornmg fhis lypo ol work will 6o cornplMcrl <br />r not. Thc granfing ol a pormd does not re5urne fo give au�hunty fo <br />rons ol any ofher sfafe or bwl law reguPlmg consUuc(inn or fhe <br />r:. Thal I am aufhorized by fho owner of fhis proporry fo pedoim fl+e <br />is rnade and I comply wrfh (ho Stnfe Con(racfors Law 18.27 RCW dnd <br />�� �� �D )2 <br />FL[ <br />50 � <br />