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11/29/2011 10:31 42589�4696 <br />ELECTRiCAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96201 <br />425-257-8810 - FAX 425-257-3857 —www.everettwa.org <br />APPLICATIONS ARE ACCEP7ED FROM 8 AM TO 4 PM <br />/y�.� S�n�f S-t- ,5�, �c��t� t✓,d 9�'��L3 <br />PROJECT ADDRESS <br />r <br />Qwner <br />Mail Addiess <br />E%� <br />City <br />PAGE 01 <br />�/�� �--�/ <br />� //// �/9 /p <br />��'`�` a�S 9 <br />WR �,QYSS c-�L u��t� <br />State7Zip Phone <br />Oecr�F�..� �6.`��' <br />y AcQN� <br />Tenant Mail Addr¢gs CRy Statr2lp P�� <br />nt.7N� . <br />CoMraclor <br />State License Number <br />Proposed Use of Building <br />Address <br />City <br />Sfate/Zip <br />Confract Price of Work <br />Contad Person (Plan Review) <br />Phone <br />1u 2 �� <br />�esuiPfion of WOrk to Be Done: oWr �/' IS EYf<H1��/` O,� �'S%L � c_ y�C �ol-�$Q�� tJ(n�l�S in specfor <br />��r•*'t'd n�w° �;rcu�!'brtn.,�6r bck iPR�'�ao.3� �i i�r jns��f;cn af�c�Ser, $K�ers — <br />rP�pPS���»� �%c�'�i� �pe�lrr�� //fS.OfG�IG/?D�S<�✓ic`G �ahc/ _ <br />....3'---� i Y <br />NOTF.: WIRING IN NON-OWELLINGS IS REQUIRED TO FEE <br />E�E IN RACEWAYS, MC OR AG CABLE. <br />%.�". O n <br />CITY OF EVERETT LOCAL SALES TAX CO7E IS 3105 <br />1 hereDy certify that J have read and examined ti:is application and know the same to be true aod � _ I/y /., <br />cerrecf. A!! p/ovisions oflaws and ordinances goveming th�s typC of wak wiU ba completed � "� UJ <br />whetherspeafied l,erern or not 7he gren6nc of a p�rmrt does nof presume to glve a�rAhoriry to l_ I� <br />vi��late or rancel fhe provisons of an�• othei stafe or local !ew regu/ating conStNchon w the <br />pe�rformance of consiruction. That ! nm atnAanzed 6y fhe owner of Grisp roperty to perform Me <br />worVc !or which application is made and 1 compty with Me St3te Controctors Law 18.27 RCW end <br />25'6.200 WAC. <br />f/!.� /'J C/' <br />