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MRR-19-2007 10:49 From: To:14252578657 Paee:l�l <br /> � j <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMII' SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 982C,1 3—I g -07 <br /> 425-257-8810 - FAX 425-257-8857—www.ever�ittwa.org <br /> � �� �0 3- Or'1'(� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 pM � <br /> ���7< <S�n;..�v> >e �.►;l� �— <br /> PROJECT ADDRESS � �'� ( ( � <br /> �i�u�►-�l'c,n,4r��r{��, O�nL,l�4�ra1. � 37�� � .�,e S � uc✓P-Ff <br /> ON�ner �.1ail Addro;s <br /> CiIY Slaie/LP Phunp � a� <br /> S�D_ �5 .ra��, �e <br /> Ten2nl Mall AdOro6a C(ty Stam2lp t'hone <br /> ���( �G�l�� ��9t ��I;-�cv�;a S-l- �'L��e�i-t�' !�� �-r'�� <br /> Elecitic2l Contractor Mad nddress rity 61ate/Z�p Phone <br /> ������� ��44s. �o <br /> Stata L�cense Number Conlrucl Prir.e of Work <br /> ProposoA Use o1 Buildinp Conlact Person (Plan Rcviow) <br /> Desc�npUon ot Wark to�e Dune: __1 �Y �) '�����a,,,.J�„ �ue L �_ <br /> virr� <br /> ��_�_ <br /> NOT[: WIRING IN NON-DWELLINGS IS RL�UIFED TO FEE <br /> BE IN FiAC6WAYS, MC OR AC CA[3LE. <br /> CITY OF EVERETT LOCAL SALES 7A%CODE IS 3105 <br /> 1 hereby caiily fhn(1 hnvv�oad ond oxarninod�his appl�catlon an�know rhe same to be true end <br /> correcl. All prov/slons of laws»nd uretin��nces gOVC+rmng fhis fypN ot woNc K�rll be cOmp/efod <br /> K�hother spoci6ed he�c�n or not. Thv�ranNnq u/a penn�t does notA resumc to givic eurnonty lo <br /> vlolete er cancel the prov�s�ens o1 ony other stefu or Ioca!law reguf�:ifing consfniclion er fhv <br /> peAormonce o/conslNdiun. 77is1 1 am authanzod by fho owner vl fhis proparty to peAJm�!he <br /> work Ivr which appl/cafion is medn and 1 compty with U�o Slole Conhactors law 18.27 RCIN and <br /> 2B6200 WAC. <br /> �� �n�.�� ���q 1�� <br /> S�gnaturv ' , � <br /> _ <br /> i-� <br />