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06/10/2088 13:42 42548P5286 PAGE 01/01 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICA710NS ARE ACCEPTED FRCM 8 AM TO 4 PM <br /> Ila /�-f l9"-" /1vC 5C s��f�5 <br /> PROJEC7 ADDRESS <br /> ��� oo �DX 139�' �f1�rw�- la.i�t- Q�9a3- <br /> Ovmor MallAddress Clty St2te21p Phone <br /> �i� FmJcys ��o�� �y�'-�ye SF Eu�r w�}- Jazod' <br /> Tenant Mail Address City Stat^/Zip Phone <br /> 2 S-'.. <br /> A�r; y�c��a,r•.� scr_,,,�� u�3tyN c���KprWyN �t�or �'.;��� wr 96i�ii 3'��--�rvs� <br /> EleCitiCalConiroctor MallAddrass City S(ate2ip Phone <br /> ��\��7i 2iJ S 'ZO�0�0 <br /> Slate Li�.ens�Nu:nber ConVaa Price of Work <br /> c�^� .'�x 2s3•a}'�•���� <br /> Propo:;ed Use of euilding Gontac,Person (Plan Review; <br /> De,criplion of Work to Be Done: /n7y�"?1tL .`�N.�%tjry f CG-r'l� S�JS�t7K� �.�D DEZ/l�l <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN R,4GEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7T LOCAL Sql_E3 TAX CODE IS 3105 V A„D� '�r,� <br /> I hereby certily that I have read and examined this appl/cetlon end know fhe same to be true and Va / <br /> correct. All provisions of fsws and oMin�nr.es goveming th.is type of wor�c wrll be comp/efed <br /> whether specified herein or noe. The granling of s permit does not presume to give euthonty to <br /> violale urcancel fho pmvisions o/any ofherstste orfocs/law regul8ting consfructron orfhe <br /> pedormancs o/const(ucfion. Thaf I am autlionzed by t5e owner o/this propeRy fo perlom7 the <br /> work for whiGt application is mado and I compty�+9fh thc Stato Contraclors Lsw 1A27 RCW and <br /> 296.200 WAC. <br /> A-��•� _ �C�.?�� �t�lU -G� <br /> Slpn�ture Date <br />