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10/07/2012 20 57 � :0947 °. 001/00? <br /> � <br /> ELECTRICAL PERMIT APRLICATION <br /> C�TY OF EVERETT P�RMIT SERVICES � <br /> 3200 CEpAR STf2EET, EVERETT, WA 98201 ���/z <br /> 4�5-257-8810 - FAX 425-257-8857-www.everettwa.org // <br /> APPLICATIONS ARE ACCEPTEP PROM e AM TO 4 PM C/��n ✓Dy� <br /> � I I D�. � "c ,�(,�� .�.E �l�' <br /> PROJEC7 ADORESS 3 SS <br /> Oo�.l ���l�t//,� /l,� //laZ 3`� ,����` Sr�. ��.3�� 6'22� <br /> Ownor MaIl/Wdroct Clty statelZlp Phonn <br /> Tonnnt ' M�II Acldross Clty Sfato2lp � Phono <br /> k 4�i��� �'�S 3l�a�� �.(� �.(/,���/ �e� a 9�.�/�� <br /> ElecUiC3lConVadof MeilAddress Cia Stato/Zip Phonu <br /> ��4A/SS/S�� l.p �- o - L.,4� <br /> Stato Ucense Numher CAntnrd Pnco of Work <br /> Proposod Use of uildinp Contact Poraon (Plan Review) <br /> ' /��+ �7 s�^y(�,G <br /> Unrcrlptlon of Work lo Ba Donu: IVi p� /S ()lL/.�/����/�, <br /> NO'I L-: WIRING IN NON-DWL"�LINGS IS RFQUIR[D'I'O 1=c'F 1 <br /> BG IN RACEWnYS, MC OR AC CA6LE. � /� O� I <br /> l <br /> �J <br /> I <br /> CITY OF EVERET7 LOCAI. SALE9 TAl(COpE IS 3105; • � <br /> r - � � �C i 2� o�-S <br /> I hen,� ccqlly 1�4of 1 havu road ond oxorNneJ rhls appl(w0on nnd know tho same to pe wo nnd � �,l — <br /> com3r.. All provlslons o/Inws antl ordiqpncay povomin 'thlS.typanl wbpr w�1166 Colnplefed <br /> whothnr spocltlnd hnrnln rnnof. Thu,pf��1Alnp�o/a purm�t�doas ncrpnisumo to.pNe�authoriry to <br /> woleto or cane�,l(ho provlslons of nnyvrhe+r sMtn or Ixnllaw,rapu/af(ng qunsfrucffon or thn <br /> peRormance o(cons�rucGon.`�am a��/by fhe oWnnr o/Ihls ropurty to pnrlorm fho <br /> 296.200 N�AC. • <br /> --. � � . �6 itu �lZ <br /> � <br /> L_ _ _ __ <br /> , <br />