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07l29/2�13 00:22 4256703922 <br /> ACTIVE ELECTIVE CORP PAGE Ol/O1 <br /> 1 <br /> ELECTt�IC.AL P�RMIT APPLICATION <br /> CITY OF EVERETT pERMIT SERVIC�S <br /> 3200 CEDAR STREET, EVERETT, WA 98201 � "��`�3 <br /> 425-257-8610 - rAX 425-257-8857—www.everettwa.org G 1���{35 <br /> qppIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I� �o1 �Yler�c��r,� � <br /> PROJECT AODf2ESS <br /> �Cd1S� - I� - r r� ��-� � _ � � �I�-5� �I � � <br /> �,ry SlatelZlp Phone <br /> O�vner Moll Address <br /> Tcoant tAoil Addtoss <br /> Ci,y Slale/71p Phvne <br /> � v � C i� - I`�� � Y�d�c�►�. 1 ��$ 1 u�� � � �S���y- b�i <br /> MatlAddress C�ty StalelZlp Phone <br /> Elecldc�l Contraclor � <br /> 1 � Contract Prica of VVork <br /> Slale License Numuer <br /> Contecl Person (Plan Roview) <br /> Proposed Use of Building <br /> Square Fool3ge (If residential new construction,remodel or addltlon) <br /> Ins�t � s�o� �ie�e �v I c�� de�'���- <br /> Descriplion of Work ta Be Dono: � '/ _ /I� <br /> � r � <br /> NOTE: WIRING IN NON-�WELLINGS IS REQUIRED TO ��� <br /> B[ IN RACEWAYS, MC OR AC CABLE. ("_ rJC_' <br /> CITY OF EV�RET7 LOCAL SALES TAX CD�E IS 3105 <br /> f horz by certifv Ihat I hove read and exeminod Uris sp�licetlon andlmow fhe same to be Irve enB <br /> cerrer,t A!I prov/s!o»s olla�vs and ordinances govemmg this type of wodc w�ll he,completed E1 ?Ll ;� � I � �? <br /> r,lie(Aerspeclfied herein ornoL The grsnling of a permif does nof resume to grvo:�uflion(y b <br /> viol��7e orcancel tllo p�rovlslons of eny oU�erstaie crfocol la�v reguPatingPconslruclion ort��e <br /> perfe�nance o/const cfion. Thaf 1 am aulhonz�d�l}fAe Stafe Cori(r/scfo spLsiv 18.27 RCW end <br /> �so�Jt� ivhich appli a-on Is mado and 1 compfy <br /> 29G,20o AC. <br /> � _����• l� <br />