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Dec. 8. 2011 1:40AM No. 2053 P. 3 <br /> —� <br /> ELECTRICAL PERMIT APPLICQTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEOAR STREET, EVERETT, WA 98201 <br /> A25-257-8810 • FAX 425-257-8857—www.everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 9 coZ�F �hcuro n Dr 6fe�'�C� q�3 20'� <br /> PROJECT ADDRESS <br /> Rumoh � c,+stt� �i(o2W Shc�ron Dr C�x'e.ft� W I�- a g 204- <br /> Owner�� ,e f� MallAddrou Clty SlelelZip Phone <br /> �c�.nnG 1Ce,;�}h�e+'' • Snr+u¢1 <br /> Tenant M�IIAddrae Clry Staterzp� pnone <br /> C�1 �}i n A �n� I'�15 f3vc�du�a.� �v8r ci� W �- �f 8 Z.ol �}25259 fob� <br /> EIOCtfical COnUiCtOf Mail Addnie City Slele2ip PhOne <br /> Cn1N�RMNqoIRq 1�30,Gb <br /> Stet�License Numb�r ConVeCt price of Work <br /> Propo=�d Use of Bu Idiny Contact Peroon (plan Review) <br /> Deccription of Work to Be Dorn: 1 V� DOIA��X I Y�� '1'1 �li� �V" �� <br /> �hrJ�� ` - <br /> NOTE: WIRINCi IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS.MC OR AC CABIE. <br /> CITY OF EVERETT LOCAL BALES TAX CODE IS�106 <br /> 1 horeby cerN/y th�f I have reed and examined fhis�pplica6on end knowfhe same to 69 frue and � �' ��l O�"� <br /> Comct. AIIp rovis(ons of/aw9 enB prdinances poveminy t/�is type o(wprk will be compietod L - <br /> whothvr spAci�rod h�nin or rrot. fie grantiry o!e pe�mi!doos nofpreSum�fo yive autAoriry(o <br /> violateorc�ncg1Me provisiongolanyothorstetepr locallew�g ulatinypconsWctlopn0orptrh�ne <br /> aro�k or wh C ap I ahon�s�m�1 erardml cuanply wth fhe St fa e Cont ecrorsplaw 18.27�RGW and <br /> 2p8.200 WAC. <br /> ` '/uuuv�_C �� � O� � ( <br /> nelure v �— <br />