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L13;18!'_'�13 ��: 11 253-G31-7754 PROVIDENT ELECTRIC PAGE �2/03 <br /> ELECTRICAL PERMIT APPLICATION <br /> � CITY OF EVERETT PERMIT SERVICES � <br /> I 3200 CEDAR STREET, EVERETi, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-vnvw.everettwa.org <br /> - - -- APPLICATIONS ARH ACCEPTED FROM 8 AM TO 4 PM - — � <br /> �z .ZSr�'L GJ <br /> PROJECT ADDRESS <br /> �o� o�n�'(o�xINYL4 mrli Crc�tc C�Y4/48oaz �12s-z.Cc8-9�1� <br /> Ovme�� Idail AOdreSs Gty Statc2ip Phone <br /> Tenard Idail AOarr,ss Cily SlatelZip Phone <br /> '�S3syi�.o�_Flt.s�r_�c��l°.�'15 '�7��� on GJ�1/9�`{Z Zss—Co31-77 <br /> Electrical Coniraclor Mall Atltlress � S�att�JZip Pnone I, <br /> ; '�,ovsESlo�GZ y,9�9 °= _ : <br /> State License Number Contract Pnce of Wonc <br /> i rx,c� �inq� �Gmi�v �t.Si�e.1K�. �.�� t�dt,��� <br /> Proposed Use of ilding ContaU Person (Plan Review) <br /> Description cf Work to Be Dane�. C-�/L/ � � v�w�}h.1/' W����r �U' ____ <br /> i __ _ c�c.c�J s�r�._��.c.. far�.�l� �eas��c,� _ � <br /> — � <br /> �I -- — - — - <br /> INOTE: WIRING IN NON-DWL=LLINGS IS REQUIRED TO FEE I <br /> � BE IN RACFWAYS, MC OR AC CABI.E. ^O �O � <br /> ! v� ✓ <br /> � r <br /> I CITY OF EVERETT LOCAL SALBS TAX CODE IS 1705 <br /> �nere6y ceRity fhaf 1 haw read arrd examihed this application and know(he samo to 6e true and I ! � <br /> T <br /> ico�rec[ A!I provisions oIlaws antl ordinances goveming Nls type of work will be complefed � I �V� —� � <br /> �.rtielher speci5ed horein or not. The granfm9 0l a permii does nof resume fo give aulhon;y to I <br /> �:�olafe nr cancel the pmvisions o/any elher sfato or local!aw reguPahng eonstrucGon or the <br /> nrrfOrmancoofconSWcfion. ThaflamauthOnzedbytheo�vnerolfhis�roperly;opeAomr:hr <br /> irorN for which appGcafion�s made and 1 comply wilb 7he Sfatn. Con;ractors La�r 18 27 ftCIN and <br /> :961001NAC. , <br /> ���J�I M�+F 1 S 2013 ' <br /> _-�;�g�aiure -- ;iate I <br /> I i <br />