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11/03/2011 14:11 142577519E� ACTIVE ENGINEEF.ING PAGE 01/O1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR S7REET, EVERETT, WA 98201 <br />425257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />19 1�- v 1�a�,v.'�a ��� <br />PROJECT ADDRESS <br />�lndga� _�t.,tc�b 191���o;r�xQ�t� E��rL t�R98Zo� Zo(a.SN4.518Y <br />Ownet Mel nOtlresc City Statel7Jp P�ono <br />L hd C; _,.ec� 151� V trc,,,.�r /�z E �4ru11 WA 48io� zoo•4v9�s�&V <br />TEnant�4 Me11AEtlrecs Cfly Stale/Lp Phone <br />c,1�� �n�;�ccr;.,c 4Vo5 zoo� S! S�,J Lynn.�oaJ, l,lA S$e3fe �Lf•aa4•5q9 <br />E�Cd1iC91 C011}f8C�0( Meil AEtlf¢56 Clty SlalalZJp PhO�B <br />(aa-4�vo. '� o�s8m5 <br />Stete Licanse Number <br />L-�n.r�_ <br />Proposed Use of Builtling <br />5 �9s. o0 <br />Contraet Price of Wotlt <br />l.S�nc $andell <br />COntad Person (Plan Review) <br />Description o( Work to Be Done: M odil., li Gi �c..1 i�-S <br />NOTE: WIRING IN NON•DWELLINGS IS REQVIRED TO FEE <br />BE IN RACEV�'AYS, MC OR AC CABLE . <br />�S• � <br />CITY OF EVERETT LOCAL SALE3 TAX COOE IS 3705 <br />th;s application end know fAa same to be <br />gaveming this type of work will be mmple <br />Na permrt doea notP resurn� to give suthi <br />rte arloca/ law �gulating consiruction w f <br />ized by fhe ownerof Mls nroperty to peNoi <br />� St�fe Contrecfors Lew 18.27 Rl <br />�/�3%B� <br />anv L�II�-U2a <br />fo <br />end <br />