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AUG. 2;. 2011 3: 29P�V EVERGk�tN PCWER SYSTEh!S, 1NC. N0. 5409 P. 1 <br /> � —1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org g— a 3 —l� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM CI���`��"1 <br /> �.50o M�ai1,L L44�1L RetiZrv�A� <br /> PROJECT ADDRE55 <br /> �M1 S�EYIL �ts� -FW.b1r1C•s Ct� (oco w�tV�tv>f,`1 � 5TE 28t, S�$LLc� �'81�1 2•1-325-7 � <br /> �8� Mall Address City Sla[WLp Phone <br /> �`F�kL� (�Sbo M�'{l.�t.Zl. C7�F�G QA4.IG�vfhf �1,� (��r �i'e.7.�t.1 7rb• (.`'S- fl�l�l <br /> 7enant Mail Address City SlatelZip Phone <br /> ' ---r� ^��•r�SL h`1��"^S �GL5 �MA4�+�M �.fAy 5••,^i1SA�jr_ �iBISM `L�L�"(7W-1�1°a <br /> ElecUicalContractor MatlAddress clry State2ip Phane <br /> .,�� �'SS`7S6"� <br /> S�l�ate Li�e Nurob� Contracl Price oi Work <br /> �'.•�u�+te-��i�• Can+a-�t�t-� ��7i��U1 �+.AVct��t z.6-77'-t-Ii;V <br /> Proposed se of 6udding Contact Person (Plan Rsview) <br /> DescriptlonoiWorktoBeDone: 3���3�38 �+S�ALI. (.�?ar�+G� sWCSGi�S � o`^Z�S� S`i$�i�n _ <br /> '.�uiln1i11�R.G rl p f�.S�i I S1 D `�? iZ�a�0. �zJT�8J '�d�FLb.v}�.+'Z id+d� — <br /> `-1�LJA '7"'RAi+ra�4�S51 <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED 70 FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CI7Y OF EVERE7T LOCAL SALES TAX CODE IS 3105 7��� <br /> 1 here6y cerfify that I have read and exemined ihis applicaGon and know the same to be true and <br /> oorrect. All prowsions o/laws and ordinances governing fhis rype of work will ba compieled ���3� W(rJAcT <br /> whefher spe�ed herein or not. The granting of a perm�t does nof presume fo give avthorlty fo <br /> violafe ncelthe provfslon oJanyofhersteteorlocallawregulafingconsfruc0onathe <br /> pe�for anc o/consWchon. at 1 am euthaized by fhe owne�of this property to psrform fhe �1 fl"� � td.•766't`��� <br /> work r whlc applicaf�on is ade and 1 comply wdh the Sfafe Contracrors Law 18.27 RC W and <br /> 286. 00 WA . ,�,.� �T� ��.� <br /> � S��-r�A��N <br /> Signa ure Dat <br /> ��p'�-/3 / <br />