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J:�n . `L5. �011 05 :07 PM PAGE. 4/ 5 <br /> ELECTRICAL PERMIT APPLICATION I <br /> CITY OF EVERET7 PFRMIT SERVICES <br /> 3200 CEUAR STREET, EVERETT, WA 98201 1 � �6•-1/ <br /> 425-257-8810 - FAX 425-257-U857 -w�ntiv.evereltwa.org ��� ��` ��3 <br /> APPLICATIONS ARH ACCEPTED FROM e AM TO 4 PM <br /> _ -- 5�;+� ca�cs __- - — <br /> 2is �a��+StCE �- . 9B�08 <br /> PROJECT ADDRESS <br /> �nSo� �;1�__�_�saS3 r�'__.�t�.�t 91l�eb �Gt.�-so�1(�Zo _ <br /> Owner MeilAddrese Clry 9ta1�Z0 Phvne <br /> ��drr�u�..__2r�.*_'��.s��f�_�,��r q9a� . <br /> enHnf AMlll Addnyc Clty Atal✓Zip Phone <br /> d I.JV�C�" ---- --- —- - <br /> [Ieclrical Contrpctor Mall�1ddre�a Clly Slatn/Ztv Phene <br /> ��� �— <br /> Slnte LIr,9nss Numb�ar Contrad P�ir.e ot Work <br /> f'mp059d U6u uf BullAl�g Conlacl Pereen (alan Revlaw) T <br /> Descrlptlon of Work W Be I]ono: .�� �t ct L�C(lO�tn��Q �jl�/1'lj�1 .�_�?2v i0 �L �Q/'b'�` ..._,_ <br /> �d--� -�a-r--•- <br /> _.. _��c�zLia_ - - - - - -- -- ------ - ------- <br /> NOTE: WIRINO IN NON DWELLINOS IS REQUIF2[D TO fEE <br /> BF. �N RACEWnYS, MC OR AC CABL[. � <br /> CITY UP EV6RETT LOCAL SALFB TAl(CODC•18 3106 <br /> 1 hCreby cartlly fhflf 1 hBv6 iuod entl CxBmined IhIA epplltafiun Hnd knOw thn snm9 fo 6e buo end <br /> uuroct. Alf provl:rlons o/len�s xnd uMlnancei pornmin9 fhls typn ol work will Ga ccmp/eted <br /> whether sped�eAhoroin v.nuf. 7he pranflnp o/e pnmr f does nof msums ro plvn eufhor7ty to <br /> �dolato or eence�l fha provls/ons ol xny other stafe or lue0l lew�epuPunp conswct;on or the _ / � � <br /> perlormence u cnnShuCNon. Thnf I mm�ufherized by fhe owner nf thla propurty fo pBdomr fhe <br /> wcrk lor which�ippllcetlon Is mndo nnd I cumv�y wlfh fhe SfeN Confrncfors Lew t B.?7 P.CW end // L� � <br /> 'l9G 200 WAC. <br /> �'� '�i7��� <br /> ��natur �. _ .�te — —. '— <br />