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04/20/2010 21:09 36041905�2 MTV PAGE 02/05 <br /> O1/13/2010 16:06 FA% 425 257 � �7 EVERETT PEflMIT SERVICES �001/OC7 <br /> \ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR S7REET, EVERET7, WA 98201 <br /> 425-257•8810 - FAX 425-257-8857—ww�v.everettwa.org <br /> APPUCATIONS ARE ACCEPTED PROM 8 AM TO d PM <br /> �����l WT . I�IJc'__T_L_rt� <br /> PROJECT AODRESS <br /> �D �ZZ IL'�I _ <br /> ����\'��1 �,I� 1� �1�1 l�C3rc��i lv€���'c1,��e 1�,,I.I`� ��,l)r� �1�Z <br /> O�me MS�I Address City Smte2ip Phone <br /> TGn8111 I.ti�lAtltlf055 Cily Sfale/Zip ( /� �� Phorfe <br /> i YV <br /> 111�r��� �►1�.�_r��-��.�tY„�_ II�L�l �yly��'���I: ��,'A,Ilt,tp i,t;l'� �12i,.U��� <br /> FICCCicaIC0�tf3ClOt MailMMesa Gty StJtEOJV PnmG <br /> �t1��\ C`� '��� <br /> SWIo Liwnse Numbet , Corrtroat Priee oi Work <br /> 1\�@�;V � �\���t C�l� ' �`�+���lD� �,;il"bYl <br /> Proposed Use of BuuAing Contad Person (Plan Review) <br /> ` <br /> Oosaiption ot Work lo Be Dono: C ��� � ��1V1 �� L �V� l'J�� <br /> ti � <br /> 'N <br /> NOTE: WIRINGINNON-DWELLING6ISREQUIR�Q70 FEE <br /> BE IN WiCEWAYS, AIC OR AC CABLE. <br /> CfTY OF EVBRETT LOCAL SALES TaX CODE IS 3105 <br /> I hcreby cprttfy thaf!have reed and exeminad ihis plicatlon and know the Seme roDe tNe and C I Q�y — (��a <br /> co�c�. n/ipro�is�onsoflawsandordlnancesgover�iingdrtstypeorti,nricwnbecomplated <br /> wheNer spec�8ed horom or.not. R�n 9rpntmH o!a perm�f does notPresume fo p7v8 audtGAry to <br /> vio(afoorcencelthn rovlsonsolanyOfhersfateOrlocsllawreguah�npconNnidJOrtprtha <br /> p Kormanco o!con�uMcn. Thot I am euthonmd 6y Ne�wrter ofthlsproperty(o perform(ha <br /> Por n7i1Gr oppGcadon lc mede and I rnmpty K1th fhv 57ote Conhectors Law 18.27 FCW and <br /> 96.200 W C. <br /> ! � �.� .. '21'ID . ... <br /> ��,a�,�" �� <br />