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i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMI�f SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �2/S t�e��; Il Creek Pk; <br /> PROJECTADDRESS <br /> S Mobc t � �C .a . Sw �+cL. go}hel� wA y25•Zy�-583 <br /> pwnBr Ma�l AOtlmss Ciry Statc/Zip F'hone <br /> I Mob,' l�/ G.a Sw�i-cl� �a�(�he 6l Wf1 �A-rnP> <br /> TCn3nl � Mail Address Cily SlatrlLip Phorre <br /> �8A \/cs�� 36a -71b - <br /> Ues�man �a�s� f�9sl L�Ma(o ShorG br• Po�lc6o ��A q837� 9`�� � <br /> EleCtrical COntradOr Mall Adtlress Cily Stetc2ip Pho� <br /> , �% //`� a� <br /> �/rSTG� 9y8PB �oo — <br /> SWIe License Number Conlrad Pnce of Work <br /> ('�II owe� CXfs-l-� nq � {qc� Ci fG�.c�f --1�v.�—�Lo—n-4��o6•57R •��17 <br /> Proposed Use of Building Contacl Perso� (Plah Review) <br /> Descriplion ol Work l0 8e Dona I�Gtd L� rG u:'�S ��� �o r M . C P. r`� be f n 4 add e <br /> 7AF�rn�—�2011 ( L.o��C Or'� Pa✓�e � l '' flOYl - T��� a- t.T v� �.no� 1 <br /> � �'-tG i s a �acZc. r 'o ln h S i d e o � -r�=d� �✓r.c� 'a�in e <br /> (o o .:S`a � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI1Y OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I horobV crortifylh�f I havc road and oxamined this applicafion ond know N�e samo!o no tme and <br /> rormcf. AI!pmvisions ollaws antl orclin�nces,qoveming fhrs type ol wo�fc wiU be�mplofeJ <br /> whother spoc+frod hemrn or not. Thc 9r.+nting ol.i pormrt doos not presumo to give au(Itonty to <br /> violafe or cancol lhe pmvisions ol any ofher state ar loc�l faw regula(ing consfruc7ion or tNo <br /> performancn o/consfrucfron �haf 1 artr auUianed by fhe o�vner o(th�s propertylo paAorm the <br /> work for which application is mado and l wmply wdh fho Stato Conlraclors Law 18.27 RCW and <br /> 296.200 WAC. <br /> - �o - Zoo- � �.�1 <br /> � (vl m Oatc .1 �� <br /> I <br /> T ' d 668UZBL90Z �uo� eueag dZZ :SO 6D OT JeW <br />