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t ( <br /> ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES ' <br /> 3200 CEDAR STREE7, EVERETT, WA 98291 q `�N...II <br /> 425•257-8810 - FAX 425-257-8857—www.everettwa.org �'/og y D� <br /> APPLICATION8 ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �SoO Me+-r: ll Cc^ea1c. �K w �F, �,�.,1kF, wd�,�t �r'zo� <br /> PROJECT ADDRESS � <br /> 5�� 1� 981a1 <br /> �/✓asin�w� �� Y.�a.l Ls��e� �o�o�i�•qA L�C 600 w„�,�evs', �.., S�' , Sc+�'� , wA�� 10 � <br /> Owner Mnll AAdreee Cly 9 ate2lp � Phano <br /> Pu !' 1� — F11�.s�z2 GSoO Me.«il� C�ee le �G.,�h.w�,� , E.,�.,re.�''� w�n . 98"La <br /> T00Bni MallAddress City ' Slald'Llp Phone <br /> G�-d�a... Sc�,�„�r�. ��43 �� A� � 5�.�-� WA °Ig134 C�za:�3sti'tl"68 <br /> Eleclrical Conlractor ail Address � Ciry T—�SletelZlp Phone <br /> GUAR-IDss2�3� •� 900 . o 0 <br /> State Licanse Number ConVacl Prica ot Work <br /> Proposed Use of Builtling Contact Person (Plan Revlaw) <br /> Oescrlption ot Work lo Be Done: Ku.�n� �-'9��'� �f ��' �a"�"�^ 0.�����5 <br /> NOTE: W IRING IN NON-DW ELIINGS IS REQUIRED 70 FEE <br /> BE IN RACEWAY5, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI 8ALE5 TN(COpE IS 3105 <br /> !hereby carti(y fhef 1 heve read end examined fhis applicetlOn and know the sema fo be hve and <br /> aoryetf. All proviniuns of laws en�uMMances povemin this fypa ol worh wIII be complefed <br /> whelher specifled heroJn or noL TNe granfing o(n perm�t does not esumo fo give euthoHry to <br /> violafa or cancol tbe rovis.ons ol Bny ofher state�Nocal law raguPaling canstructlon or fho — D /�n <br /> pedonnenee o/consPrucllon. Tnaf 1 em autnorized by I�a ownar of thls proparty to pedorm the I///r <br /> work lor whlch npplicatlon is made and 1 comply wifh Ille Sfefe Gonlfectors Lew 18.27 RCW end ^� ��� <br /> �96.2�0 WA4 , I" g <br /> p9 � ly/ ll _ <br /> slynalure — Date <br /> id WdZO:ZS TTOZ bT 'daS 066b-8z9-90Z: 'ON XFi� .11lafl�3S NbIQ2itift�: IJOb� <br />