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FRpM : DIRMOND COMMUIJICFiTfONS FRX N0. : 4G5 413 3904 Mdr. 19 2008 02: 16PM P1 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CED�R STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.orp <br /> APPLICATIONS ARE ACCEPTEO FROM 8 AM TO 4 PM <br /> q c%� S,e.��s �uccy B\vd e S���►o� <br /> PROJECT ADDRESS <br /> rs���i ��i- ►-�-��,,;, (�o,,r �i ����-a�3-����. <br /> Ownet Mnil Addms6 City SmtelZip Ptwne <br /> CC;�ll1(�.\^Ct ,� d�'�e� <br /> Ten2n1 ry1a��Adaress City Stato'Lp Pnone <br /> �G�G+����C� ��i�»�u��i�C $iO�nS.T� �� l�k q n I�{O�vac-1-- vJfl- `) 6'U2S ��Z�-`f3a-(dYn <br /> Electrical Cortractor Moii rwtlrecc aty Statei2ip Ptane <br /> �q-��� oc_sys���s� 11 � I ��'� J.�roo�` <br /> S1ale License Number � 1 I ConVect Prica of Work <br /> � I L�.ma,f- Gzud��/ <br /> �����e,rc� a,� <br /> Propes¢tl USC o(8uiltling Contatt Pefson (Plan Review) <br /> Description oi Woric to Oe Done: 1COl.lL�v� � �1 U�'l�� ()'Y C �11"��'Y�I�.V'\1 C(.l'�'t �1'1 l C��7'L����(i <br /> � � �C��� tc,��� . <br /> NOTE: wIRItJG IN NON•DWELLINGS IS REDUIRED TO FEE <br /> �E IN RACEWAYS, MC OR�C CABLE. <br /> CITY OF[VERETT LOCAL SALES TAl(CODE 1$$705 <br /> I noroby certily thef/hsve re.vtl an0 orarninod this applicafi0n And knowlho snme to be fnie and <br /> corroct. AI!provisions o/laws and ordinances yoveming th�s type ol work wi;l he comp/efed <br /> whellrer specifi�yd h�re�irr pr noL The grtmting o/a permif doas not Pinsumo M givo sulho�iry to <br /> vrolafe o�cancel7ha ploV�5ion5 Ol any ofber sfatx w local!aw/ogu/�tlny ConSfrocfion or fha <br /> peAortrianr,e oJ construclion. That f am a�thonied by the owner�ol fhis property to peAorm fha <br /> wnrk!ur which applicafion is matle and 1 compty�•�ith fhe State ConVac(ors Law 78.27 RCWand <br /> 29G.200 64'AC. <br /> // 1 C'�G�� ,3��c��,�. <br /> S�ghature —CTate _, <br /> t- ��� 3 �>a5 <br />