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lU/C�6/2009 12:?5 36�2941066 ERbJIN ELECTkIC PAGE �2/02 <br /> � i <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STRE[T, EVERETT, WA 98201 <br /> 425-25I-E3810 - FNC 425•257-8857—www.everettwa.org <br /> ApPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM IO � t�—O <br /> �C o ���j- D� <br /> I�o d� 2�,c Gkc 2 ��� . E�E2�� r w�- q' 8Zo 1 <br /> PROJECT ADDRE55 <br /> G���N McMas-r�� . �l007 RuckGF� Av �V�Rt�'r- t�/✓+ 9�12� <br /> -� <br /> O�rmer IAmlFdtlrass City State2�o � Phoiw <br /> �1Z5 •359-72v <br /> Tenant �aadnadmss C�ry Stata2ip P one <br /> �25 -�9�-vao <br /> L2hJ/f�/ F_�EG721G LLG • / �2�' �{V. � �5/� S�Jc�l�ovit�5ld G�I/,�' �182 D <br /> � <br /> EIeGIrIC�ICofltf3dOf I,7tilAJdress Ciy S1BtC2ip Phone <br /> �2W i,tl�L 9� �GP �I, '7 � � � <br /> siace�iconse Number Conlred Price of Work <br /> I'roposeA Use of 6uiltl�ng Contact Person (Plan Review) <br /> Descnption o(Wurk to Ge�one: ,�5��L` //�/n/ 7 QA. �2�D ✓ G'l.el/,1i T rf/Q <br /> i -- <br /> � 7��STii.lC-��R�l- Nf�--��_�i✓ 2�° F�oo� _ /.'t�nl�'i2c.u� r <br /> �O ;i- 8D x (N GAunlra2!/ 2�1• <br /> NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FE[ <br /> BE IN RAC[WAYS, MC OR AC C��LE. <br /> CITY OP EVERETT LOCAL 3ALE3 TAX CODE IS�'105 <br /> 1 hemby cerh/v th�(I havo ivad and ezsminaU Ihis api�;ication end Fnow fho san)e tu be:rue and r J�i O` ('1(1/ <br /> �urmct. A!/pinwsons o�laws anAortlinonces gowminy(!1(S type oI u�ork will Du COmpleted J(7�' <br /> u heLtier specdied haiBin o�nof. l'he yranting oI a pBl7t7�f tl0es nof presumB 70 give Qutho�dy lo <br /> v�clato or cancsl(ha prerisrons v7uny olher sfste u�Ixal law requlsting conaLzichon or;he <br /> oeifoi,-nUnce eI cvnsnuC,io�t Thst/am aulhonzod by 1he mvne�01 th�s property to peAom�the <br /> �+�orA lor whicn appilcaUon�s mad�antl I cemply wi;h thc Sfa�O Contmcfors Law 18.27 RCW and <br /> -:90 700 WAC. <br /> �r$�vlil � /Lt' !/v� ��� �O — Q� <br /> �ipnatura v `Data <br />