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98/05/2004 14:18 425-775-8969 MIPlUTMAN PRE55 PAGE 01 <br /> i ELECTR.ICAL PERMIT APPLICATION <br /> CITY Or EVER�7T PERMIT SERVICES <br /> 320�CEDAR STREET, EVERETT�, WA 9&201 <br /> 425-257-0810 - FAX 425-257-8857-wv�nv.everettwa.org <br /> APPLICATIONS qRE ACCEPTED FROM 8 AM TO 4 PM -DEBIT 8�CF2EDIT CARIJS ARE NOT ACCEPTED <br /> �7 ���� PL� . �'����.�-- <br /> PROJECT ADDRESS <br /> ✓�'�57�1�'LS(l�" ��nu,s Glic_ �h'-�` �hn,.wt,�o � / �g �A5 /-du-l.so-ts� <br /> Owner Mail ACdreos � �Ciry Smte2p Phone <br /> , / / <br /> ,v/�C - <br /> Tenant Mail.�daress City Shte/Z�p Phone <br /> �� �' �� ��a� s��� ��� Q.� �w.�`�,�9 9�c�OS dd63`7�/-79 <br /> Ele:tdcal COntlactqr Matl Addres3 Ciry StaWJ'GO Phone <br /> ` ib Ud �' Q� �� � 3. 2o't7, ��i <br /> Sate License Nwnber Cantract Pnce of Work <br /> �J �� � r <br /> Proposed Use of Building Gontact Pcrson (Plan Review) <br /> Descriplion of Work to Be Dona: � `D6 u � `��V{�—r <br /> �G �t�r� S� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FE� <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAI SALES TAX CODE IS 3105 <br /> I hereby r,eRify7hat 1 have read and examined Ihls appllcation and know the same to be tn�n and <br /> correcf. AU provisions o(/aws and ortlinances gevernmg this type of wcrk wil!be completed <br /> wh�ther:peci�ed herein or not. Tha grarting of a permi(Uoes nct presume to give aufhodty to <br /> ���ielateor::anceffheprovisionso enyotirerstatecrlowlfawregulatingconsttucuonorfhe <br /> pe7ormance of con tr�ction. T,Se /am auNonzotl Dy fhe owner of fh�s property to pedorm the <br /> work icr ivhic o/ a ' is mad znd I comply with ihe Sfate Contraaas Law 78.27 RCW and <br /> 296.20G lNA . <br /> � � o ,� <br /> I � <br /> Sig aIl• Da�a .. <br /> ��i <br /> /I r <br /> .i��j, <br /> I <br />