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05/01/200B 14:57 4252592794 SEAHURST PAGE 05/08 <br /> 1 <br /> ELECTRICAL PERMIT APP�ICATIC�N <br /> CITY OF EVEFtET� PERMIT SERVICES <br /> 3200 CEDAR STRE�'f, EVERETT, WA 98201 .�� ��� <br /> R25-257-8810 - FAX 425-257-8857--www.everetiwa.org �DgO S—�� <br /> APPLICA710NS ARE ACCEPTED FROM 8 AM TO b PM <br /> 1D9�� �7r`� Av� �✓�eErr - <br /> PROJECT ApDRESS �� <br /> �v�� �on� ��r,��c_. r �Z;_37ij D,�r.�s vE, ���crr G�fA yBZol C�+zs}gyyA 7 <br /> Owrier Mell Address City Stata2lp Phorre <br /> 17'1�,��'o� F FM�T�r <br /> Tenenf Ma�lAddrt�ss City Slate�2ip Phone <br /> SF�uPsi ����� �9/S CHEsrti�� F,,Fo.��r G�a 9�1 �yzshs8-�a�z <br /> Eloctrical Contractor Mail Addre39 City St&t¢/zip Phof18 <br /> S��uirEr �99ati �/568 . UD <br /> State License Number COMraCt Price oi Work <br /> SG�hl40` I / L�Q��,_ <br /> PropoSed Use of 8uila�ng Caitact Person (Plan Review) <br /> Description of Work to Be Done: �i1/S%�G�- C'QQ/DU!i �AGF�i//�Y �O/_� F/�rI , � <br /> �i 8EP d� Pi/C__/;,Q�GF livsi At�ATrO/r/ _ <br /> NOTE: WIRING IN NON-0WELLINGS IS REQUIRED t 0 FEE OD <br /> DE IN RACEWAYS, MC OR AC CABLF. ��� <br /> CITY OF EVERElT LOCAL SALES TAX CODE IS 1105 �O�� �1� <br /> 1 herebY cer(ify thaf I have rend ar.d exnmined this sppliceflon and know the ssme to be tnie and �i <br /> co�cf. All provlslons o/laws end ordinences goveming thls type of worlr wlll be completed <br /> whether specified herein or not. The gran6ng of E�pertnd does notp msume fo give authority lo <br /> violata orcancal tha provisio»s o(any otherstats or local law rpgWating�pnStNcfion or the <br /> pedormance o/canshvcHon. That/em euthonzed by fhe ovmer a/thls property(o perlorm lhe <br /> work(Or which appfication is made and!compty with the State Contractors Letv 7ft.27 RCW and <br /> 296.200 WAC. <br /> o-��_ ��/ �UB <br /> Signeture o ra --- <br />