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03/18/2�13 08: 11 253-631-775J FROVIDENT E�ECTRIC FASE 03/�3 <br /> �LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PEkMIT SERVICES <br /> 3200 CEDAR STiZEET, EVERETT, WA 98201 <br /> 425-257-881U - FAX 425-257-8857-wnvw.everettwa.org <br /> ' APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ! <br /> I-- -- 5� -- - --- — - i <br /> �� PL GJ i <br /> PROJECTA��RESS <br /> I <br /> �o�n�t 4on�lowv�s�'O1�oxIHYL�! r�'t;ll Crc.aGc G�t/98aaz 925-uc8-9�Itl <br /> Owner � Ma9 ACtlress City StateiZia phone <br /> Tenanc � Mail A�dress Ci,y SlatelLip ?�o.�c <br /> t-S4V.tl�[��i�L.C��fa��C11]_�_7����0�._ �198C1�{Z ZSS-�03�"7�5C� <br /> ElBctnG21 ContraCtof 1.7ai1 Address ity Stalef2ip Phone � <br /> �a��3to�Lz �f�91 � -- i <br /> State�iwnse Number Contract Price of Work � <br /> �JCJJS��d.Y�.1LV ��J .�11y5- -�_��_ __— 'i <br /> IProposetl Use of ing Contact Person jPlan Rev�e�•t) � <br /> (� I <br /> I)r_5cnptinn ol Wo�k to Be Done. y�O 0..� ���d..�QL W�`t�� �" ��/" __ _ <br /> _�v✓L �r' � Siv10,1Z. ��.a'�'�i��5��— — <br /> � �r <br /> i - — <br /> '� i <br /> NOTE: 1MRING IN NON-DWELLINGS IS REQUIRED TO FEE � �I <br /> �E IN RACEWAYS. MC OR AC CABLE. �=�., I <br /> II CITY OF EVERETT LOCAL SALES TAX CODE IS 3�05 � �O �� <br /> i f�ereh y cnrtdy thaf I have read and r,,anuned fhis application and know the sa„m W De trve ana 1� � �J � � �.:.- I <br /> correct AU prov�srons ollaws und ordmances povvmmg this typa of work wlq be crompfeted (,. � I I � � <br /> �vhefher spe,r,frerl horem or nof. The oranbny ot a penrr�t dnes nof pmsume to give aufhonty lo <br /> wo�ate or canr,N the p,rovisrons ol any ufhei sfafe or local law regulahng conshucfior, or the I <br /> perJormancn o�consbuchnn. That 1 am authonzed by the ou�ner of fh�s pmpeRy fo perlo;m the � <br /> � vork Mr which apPtrcatron�s mode and 1�ampty wi(h fhe Slale Con7ractors Law 182i RCW and I <br /> � z?s2oo w,�r. I <br /> I ��J MAR 18 2013 __ I <br /> Siynalme U2te <br /> I <br /> i <br /> I._ __. '—"____— "'_— '_" _ __ —" " '_. . I <br />