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11I27/2N12 10: 42 2065684117 PAGE �2 <br /> � I� <br /> I <br /> ELECTRICAL PERMIT APPLICATII�N <br /> � CITY OF EVERETT PERMIT SERVICES I <br /> I 3200 CEDAR STREET, EVERETT, �NA 9g201 <br /> 425-257-8810 - FAX425-257-8857-wwu�'•everettwa.org I <br /> � APPLICATIONS ARE ACCEPTED FROM B AM TO d PM <br /> I <br /> `llo�-I Srt!}fZoN oS��VE � <br /> PROJECT ADDRESS I <br /> LOR1 w��LS 91�31 Sr1�tRoN flR�v� EveRCTf v� � qsz.a'+ �z5 "QZ6µ9 I <br /> StetCr2lp Phonc <br /> pwner htnil Atldres9 C�h' I <br /> q(yzl sr}1}�ari DRiVE Ev�RErT wA� q02��i- 4-15- $ � I <br /> I Clly 5talel7ip Plrone I <br /> Ten3nl hlail AtlCress <br /> I SMC iNC oFSEPrii1-� 926PoP�RRPLS SE�1T�-� wh A�bi�4�} 153 -3?���. I <br /> Electrical Contractor �1ail Adaress �'�Y <br /> State2iy Pnone <br /> I (001- 5Z�4- 252 I <br /> State ucense Numher Contract Price ot Work � <br /> I — I <br /> I Proposed Use o(�uilding CoNaCt PergOn (Plan Revlew) � <br /> ISqua�e Foolage(If re tl�0�1 new C0115iruc1io0, f0tnodel 0�8ddilio0) <br /> I� Descnption ot Wark�o ee oone: _ R G W 1 RE M�TC � 0 `�aOX ' — <br /> � <br /> � I <br /> NOTE. WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS. MC OR AC CABLE. � D ^ ^ <br /> � <br /> �� L� � <br /> ICITV OF EV[RETT LOCAL SALES TA%COOE IS 3106 <br /> 1 hem6y certdy fhot I have reJd and ezammed this 9AP��cation end kno�v fhe 5ame lo bo fruC nnd <br /> r.orrecl All provisions of Imvs and oNinnnces goveming this type of wark wiA be,cnmplefed I <br /> i �vholher specdiud herein or no�. 7be g�anGng o!a permrt does nof p25ume fo grve aufho�ify fo ( �+ � ' I� � <br /> ivro/steOrCance/the p��+Si0�5Crany0U1B�S�aMOr10Ce��awf�qUlatingConSVuctionolihe _ <br /> ponarmance oi rnostruchon. fhat I am aulhoriied Gy the owner ol fhis p�Perty to perform fhe <br /> work lor wnlch npn��cnhon is madc qnd 1 comn� ��'i�h Bie StBte ConlraC(Ors Law 19.27 RCW end t'j <br /> ' 29@POD bV�IC. <br /> ���i��,��'� a i <br /> � �� / �lan�� I <br /> IJignBlu—� ��'" �� = Ualc <br /> I I <br />