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�6/25/2�08 21:46 4256702442 CITILIGHTS ELECTRIC PAGE 02/02 <br />ELE;CTRICAL PERMIT APPLICATION <br />ClTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR ETREET, 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 />a �l c �ou all�� <br />PROJECT ADDRESS <br />_`��?�� ��Ue Ne <br />�C� MO�i Address <br />Tenent <br />� � � 5 �� <br />' I C nVayl r <br />MailAtldress <br />Mail Adtlrees <br />2231 f�� �OU <br />CY <br />Cily <br />��q�o �(Monds <br />Electnca o ��ry <br />� � ! <br />�,�������� � �� /:� <br />Sta�e License Number <br />P�oposed Use of Building <br />��V�..7 � � <br />Description of �'Jark to Be Done �"� y V( C"4� <br />l i ��i (�Q <br />stotenia l �°-� oat na <br />Slele2lp Pt+ona <br />rv���Q a �oa c� <br />Stalelzip Phone <br />�-iO00�U <br />Con�ract Price of Work <br />Contact Person (Plan Revie�v) <br />NOTE: WIRING IN NON•D\VEILINGS IS RE�UIRED TO FEE <br />BE IN RnCEWAYS, MC OR AC CABLE. <br />CIiY OF EVGRETT LOCA4 S��LES TAX CODE IS 3105 <br />I hera6y certity lhat 1 have read and exomined tbls app�r^clipn and know the same lo be hue and <br />crormcc AII pruvrsions ot laws � nd ortlmnnces go�rem•nq fh�s typo of �vork K�pl be. completed <br />whefher spea0vd hercin or not The grsnflnq o� a permrt does notPmsume to g�ve aufhonty fo <br />violyte or cancel fhe p�v!sions of sny ofher slr+te or txal !aw regu af�ng construction or the <br />peNormence of GonstiucLon. 7 hat I am a�thonxed Gy the �wner o! tbis property fo peAorm �he <br />wnrk �or v:hrll�+ibnficatIDn �s m ide and ! eOmply wilh (he Sfate ConVectors La�v 73.27 RC W 8nd <br />__ (�(2�/04� <br />—� o�i� <br />1 <br />-� <br />>C, -� � �, <br />