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DEC-13-2010 10:05R FP.019:DRHL ELECTRIC-EVERET 425-252-2999 T0:4252576B57 P.1�1 <br /> ELECTRICAL PERMIT �PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.evereliwa.org . -� � -�J <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM `��z C / � <br /> �I�S.T,� ,��� • <br /> PROJECT ADDRESS <br /> TZS <br /> ?oY.�f1�,� � �i,�1��3s�� S�r�,Q� E✓ �aZo� <br /> Owno� Idail Address City SlatelZlp Phono <br /> �_�S .�BD(/�'_ <br /> TenaM Mall Address Ciry Slale2lp Phone <br /> �����,� �oq��ou�� ��- c�� %�,� ��zo, �zZ� <br /> Eloctrlcal Conl�acl0r Mail ACtlress Clty Slate/Zip Phone <br /> DAr���l 92� Q D �/5�. o0 <br /> Staln Licnnsr Numhcr Contrnct Prico 01 Work <br /> O FFICE /fjj,4,t�cl.�",4�TU,e /�lI G- <br /> Proposod Uso oi Bu Idin� Contact Person (Plan Reviow) <br /> Doscriplion of Work to Do Dono: _�il.J 5� ryL�- �E�L.ly�c.� ��11� T /"�ac.��� <br /> ��-- (��rLJ�,e�SScae � �l.�sY�tlG-�"T� �?�i�'1 ��E O,t� <br /> /��Tor3G�-- /�� 71�/'O <br /> NO7E: WIRING IN NON-DWFLLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> �� j'D <br /> CITY OF EVERETT LOCAL SALES TAX COD6I5 3105 <br /> I horeby certil}�O�at I hove�oad ontl exarninod Ihis applicatlai and know Iha samo to bo true ond <br /> corroct. All provisions o/lau�s and oroinances goveming th/s type ol work will be complefed <br /> whelhor spoafied hcroln or not. Tho gn7nfinp ol o p vmd doos nof Presume to glve eufhoriry f� <br /> vio/ale or cnnccl tho provisions o/anv othor stnle orlocal law ropu/eUng construction or the / <br /> poAarmanco consiructlon, That 1 om authorizod by fho ownorolfhls proporty fo pallorm fhe ' <br /> wark lor wh� I �pplicotlon is m�le ano mply wilh fhe Sfate Confrectors Law T8.27 RCW and � ( <br /> 29G.200 A . /`2� ,/ / <br /> // / . � � <br /> ��- /Z 3/ic'� ��� � <br /> Sipn r Date <br />