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FF.01•1 :GURRD I RN SEQ IR i T1' , FRX IJO. : "�p, 1D 2009 02:57PM P2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, EVERETT, yyq gg207 n /� �� <br /> 425•257-8810 - Fqxq25-257-8857-www.evereRwa.org 7�"�7`'"v� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO�PM C�� <br /> �v�" �u���,�/�-�� <br /> PROJECTADDRESS <br /> ��/t L(�lLr�- ��.�L 0� D / /1't/� �U�R�rj QJ/r 7 <br /> Owner Maflqddress � ciry <br /> State2ip Fhone <br /> Totlan�� MadAtltlress 7U�o 4�� ��Z <br /> �"h' State/Zip Phone <br /> �' ����A.�s�2� �-�� = �-�43 isT �� s�.��r� w� Rg�3y �°ro bz'L <br /> Eleclriwl COn1�oCtor A1ail ddreas City Sla�rlZip Phoe�e <br /> �����.� 5 233K5 � y�e � <br /> Stnte License Number Contrect Price ol Work � <br /> �C.�C--__/�1../i ti�L /f�t'/�Iu/ �i�_ <br /> Proposed Use of Builtlinp ConWct Person (Plan Review) ' <br /> Descnption ot Work to Oe Uone: �NST��� A r r a sS �i��,f�O l ��{��� <br /> ��( � �c�fl �2 l� JL��'C�-/1, i��� <br /> � <br /> NOT[• 'NIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN ftACEWAYS, h1C OR AC CABL[. <br /> CITY OF EVERETT LOCAL SALES TAX CpDE IS 3105 <br /> l hereby cerfi/y fhat I hdve read and examined 7his npplicelion pnd A»Ow(ho samo�o bo hus antl �„�C� �[.r i'� �C <br /> co�met. �ll pmvisions o/lan�s and ord�nunces goveming thrs type ol work wii!be completeJ L � � (,���,� <br /> �vnefhe.speciF,ed heroin or not. The granriny ol a p xrmrt Cees not nrsume to give sufhonty to <br /> violalo er cance!�(re p�ovisions oI tfny Otho�stale�or local Isw reguPotinp construcf�on or the <br /> potlomran:v o! nsirvclion at I am aufhunzml by fhe owner o!this propeny to pedorm the <br /> uro�k!or uhrc plica!ion is � qe and I cornpty�n,h fhe S1a;u Con7racfors Lsw 19.27 RCW and <br /> 25G.20011' ., <br /> �i; <br /> �-� �v v <br /> Signntu�n Date <br />