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03/OB/2012 TNU 13s30 PAx 6252642a05 Aqua Quip �001/001 <br /> � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> I <br /> 3 �Zo �,��� �� CJ�.n �� q�u�3 ' <br /> , <br /> PROJECT ADDRESS ( �U6� <br /> � <br /> �� �'Il`J�� 1`4�V��` � r �... ��+.. <br /> 1 �� �.�<�i � �y���n �a�� ��� � -. . <br /> Owner Mail PCEress Cdy Slate2lp Phone <br /> �f�l�� <br /> TenB�l MailAtldress City Stela2lp Phone <br /> �� ua�u�a ��C�5�1 ^'�1��=�� �To�t �,,�A �'1�"i �2�c� <br /> EIeG ical Contractor Meil Addrose Cky Stata2ip Phone <br /> ��.U'A��-9�L� � ��S � <br /> State License Number Cor ract Price of Work <br /> �aE u���� <br /> Proposed Use of Buildiny Contad Peraon (Plan Revlew) <br /> Descriplion of Work to Be Done: �V N �Jt.���-A���J �\QS�'.1,��Z' �U� F�O�U� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODF IS 5105 <br /> I here6y certlly that I have read and examined this epplicaBon and Mmw the same to be hue and <br /> cortecL All provisfons o(lew3 end ordinances goveming(his type o/woilc will be complefed �1'��� -C7 S� <br /> whelher specfied hereln or not. fie granfing of e pemut does notp resume to giva authority to <br /> violate or cancel fhe provisions of any otherstate orlocallaw regulaNng construcfioi orfhe <br /> peAormance oI conshuction. Thef 1 am aufhorrzed 6y the owner o/this property to peAorm fhe <br /> work/or which pl' edon!s e end 1 comply wifh the State Contrectora Lew 1 B27 RCW and <br /> 296.200 WAC _-�/�n�u��4'G� <br /> �Z'�� --- 31�, �.C:�1'L. <br /> SigneWre � Oate . <br /> {�'kc <br />