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RPR-05-2010 08:56 From:TRI TEC COMM 253 852 5660 To:425 257 8857 P. 1�1 <br /> - ` <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES G � 5/o <br /> 3200 CEDAR STREET. EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org �100�%�-(J�/ <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> a80( 23�p 1�'GJr (w��cr <br /> PROJECT ADDRESS <br /> Kt5- <br /> T Y'1 <br /> D„rt+,� h"•r�n_�ti�cL�v h�t05 71�E"�:�L.tZ��rnc��.. Wk `l�'o0`t3 87� <br /> Owner MailAddress City Stflle/Zip Pnonu <br /> Pu:a�, Yu _r�c, A•ar+�r�..xa , (y,p� �lY+� �1r �` luo�,su,►�l�.cw� (�-St 9�o�t3 ������,,� <br /> Tenanl �dail ACdresa Cily Slale/ZiU Phone <br /> �. 3' <br /> L, l.L^" �P� �i� � <br /> 11ZL'S!�''L�i�anna�us.c�i �. S(3u ���� /ku� Il�; ?7T7 <br /> Electrical Contractor r.lail nddress Clry Stale2ip Phone X � <br /> 7'a�iF.� � onnb� 3z,EP� , �` <br /> Stale License Number Contract Price of Work <br /> � _VLdl�2r�ltiC_ roW1�:Yy , �car4r15s�] <br /> Proposed Ure of Buildiny Contact Person {Plan Review) <br /> Descrip�ion of Wark to 8e Oone: �„� `�p _T7qf�{_ �ULi L r �M"� (.q2� <br /> NUTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF [VERFTT LOCAL SAIES TAX CODE IS 3105 <br /> I, � c'Ol.�- O � I <br /> !ho�eby corlily fhel 1 hsve read aod oramrned fhi5 applicalion and kno�v the samo fo ho true a�id <br /> c�rrecf. All provis�on�olldtvs and Ortlinences gove:ning lhis type of work��•ill Ue comp/efed <br /> whclhor spoci d herorn o�no�. The grsnfing oia pemi�t dovs not presume lo give author;ry fo <br /> viofafo or'ca ce the provisions of any GihBrSfafB O�loC31lu�i feyulsfing cnnstrucfion or(ho <br /> performanc ol� n.�(rucLon. Thaf 12m au(hon.eU Ly(he otvner of(his piopeRy(o pedotm 7he <br /> �,�em�nr w�icn aJ pi�•plion is mede antl f comply wifh fhe State CUnfreclors Law 73.27 RC W an0 <br /> 296.2001M1 C. / <br /> I � � <br /> i alu te <br />