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Jan-24-11 11:32A <br />ELECTRICAL PE:RNiIT APPLICATION <br />CITY OF F_VERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX A25-257•8857 - www.everettwa.ory <br />APPLICATION5 ARE ACCE PTED FROM 8 AM TQ 4 PM <br />—.� /�_s� �,_ � �o�V.14 c <br />PROJECT ADdRESS ' <br />yas <br />1.r.z a.Z�S <br />P.O1 <br />G02�K.L 3/.�S .'L1�D �cl,�L. ,�G/ 9f�G/ <br />Owner �1ail AdAress Gity Sia1e?ip Phano <br />Ton2�t1 61;�ilAddiuss '. . �ity Stntr2ip..—. . pryorc - <br />�tl�'�S�.�RL �z_f� ,�(�—�: �� , ��r Y�.I �S'�' Z/4/ <br />[Ieclrir,Tl Conhac�ur Mali nddiess Cily Sla�aiZip Phnne <br />L ,i %�Gvp <br />,FfGif/i/.f�l�/S�� L!� ��� ^ l���VNxif <br />Slate Liconse Number Contr�ct Prica o114�ork <br />�O,Lt�,i,� <br />Proposad Use ot Bwlding <br />Conlact Pc�rson (Plan knview) <br />Dascriulion o1lNork tn �e �nne: 'J� C.l,(tL (i/��ti,_�i. GG -/•'V �MF/�•�C11 ./�/S'��(.L <br />NOTE WIRING IN NON�DWELLINGS �S REQUIRED 7q <br />E3E IN RqCEWnYS, A1C OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX GOOE 19 3705 <br />FEE <br />Ct.S9� G�9o�nr.1 <br />f hereb}� cortily Ihat I Iravo read and ezeminad this applrcefion anJ kr,ow (hu same !o be true and ���kl(C iN 1�-�. iJ� <br />�vnecC AU prorisions olla�vs aud niilinenco5 ovemin rms �• e or ��onc �n no, cum iered /_ � o <br />whuther spc�crl�ed horewi or not. Tho �ranfing �I a pernr�t Aoes pn( u:sunte fo 8ivo aulhority fo �� n- (P y- <br />vlola(p er canCt�l tiie provisions oI any o(her s�nro oNoea!!nw re�u�nGng constRiCflon o� fAe <br />pedormance o/cons(ruction. tha! I am aufhorized by fhe otvner uf Ih,is pruperty fo padomi Iho %�; �-� �j,��{�ry <br />nark lor wh�ch ap lic,�6on �s mn�1c� and ! conp�ly �tiith fhe State Cvntr,icfors Lnw 1t1.27 RCW anA <br />29G.200 11!4 . <br />' Rl�ir� <br />/ � 2Y r <br />ti ln o ` — '� d« .� �\�V 1'_ U� 1 <br />✓ <br />