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12/19/2012 12:05 14257751960 ACTIVE ENGINEERING PAGE 01/01 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857–www.everettwa.org <br /> APPLICAIIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �noL`�c �il�an6r `� \r�-c.e, — <br /> PROJECT ADDRE55 <br /> r�_ ,._i., r���.._ GG2�- �� ,.r �\t�te. Cv.e.�-�.�ti 1�.�lk �1 82o's <br /> pymef MailAddress Clty Stete/2�p Phone <br /> Tenanl �dallAddress C�ty Sta�e2lp Phone <br /> L� k'� ' cc t c�l�h$ LW�"'S�4 S W �--`1 n wucsa l�.j P- 9 h o3 C� <br /> Electric&IContrndof MallAddress City Stata2lp Phone <br /> (.� :�,v..,. '�` o�sfs N'�� �so�' <br /> State Lia�nse Number Contract Price of Work <br /> Proposetl lJse of Building Contact Person (Plan Review) <br /> Square Footage(If resid>ntia�new construction, remodel ot addltion) <br /> DescnptionofWorklo8e0one: r1�sc.o�s.cc� �IZ{Gorr��.�' �vrnnc <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �O . � <br /> � CI1Y OF EVERETT LOCAL SALES TAX CODE IS J106 <br /> �heroby cartiry thaf 7 have read and uxamined fhis apqlicatron and know the same to be frua and <br /> mrroct. A!!pru�lsions o//aws and ortilnances govemmg lhrs type olwork will be cvmplefed <br /> wholhor spocifiotl heroin or not. The g�anfing ofa pormrf doos nof presume fo glve aulhorlty to <br /> violote or conc�/!he�rovisrons olony other sta�e or loco!!ew rogalo;ing consfrucGon or the <br /> perfomisnco of cons ructien. That!am aufhanzod by lhe ownor of fhis property to pedontr tbe <br /> work fcr which ap0iicafion is made and 7 comply with 7hP Stato ContrNCfors Lsw 18.27 RCW snd <br /> i9ti.Z00 WAC. <br /> �� � �--� i z- � i 1 � i L <br /> Signxtum D8�0 <br />