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12/22/2008 22:45 2�65684117 PAGE 01 <br /> � o� � L� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDqR STREET, �VERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857–www.everettwa.org <br /> APPLICA710NS ARE ACCBPTED FROM 8 Abt TO 4 PM <br /> 23n0 �le�r i � ( Greel�. �ar��1�i c� <br /> PROJECTADDRESS <br /> 4�25— <br /> ��u.s N VJ �15 �Il�r�-R�es� �30o Q,�,I�v�,,e, wA sSa�s y�7_z�zs <br /> �« Idnl Address Ciy Stsle2ip PhenE <br /> y.z5 - <br /> JIS l �� �e sE #3oD �e�lcv�ne �A JSoaS yb� -z7zS <br /> TenaM1t MeilAddress Clry Slala2iD Ptwna <br /> ��� �le���� 1 Co�rlrac�YS 82$ t�c�l�r �lr�rp �So �a,-klfeil�lA 32q 2040 <br /> EleqricalConlrector MallAdtlmss �;�y 5����Z�p P�e <br /> SM� II�S�` 0(of�D,� � � 3�,pDp — . <br /> State Licenso NumDer ,/�S l� Contrad Price of Work <br /> Cov� rnerc�e�.� :�f� y �(!�� 1,��'erlizl�d.�r�e 2o(r-yfi8•3sya <br /> Pmpoeed Usa oi Building Contact Person (Plan Review) <br /> t 1 / <br /> Desuiption of Work to Be Done: r' � S � �1G1 ll � ZODf� 277 0� <br /> o.�� C�� 4s �Va �tsov -� �Zo/�og i�ar�(n; <br /> add C � S 2o ssV n�l <br /> Srv�si z - ►I 3 <br /> NOTE� WIRING IN NON-DWELLINGS IS REQU�RED 7C FEE <br /> B[IN RACEWAYS, MC OR AC CABLE. <br /> ���� — <br /> CITY OF EVEREIT LOCAL SA{,ES TA7(CODE IS 3705 <br /> !he�oby certity lhat I hovo rood and oxantined fhis opp7ica(ion and know fhe same to be We and � ��� <br /> aurocL Alf provlsions ollpK�s and orJinnncas govemmy thls:ypa of work wiU be comp7etod <br /> whothorspaci5od hnprero�n or nof. T7ro gr:mtrrg of o permi(obes nof resume to give auchonry to ` � - - � � <br /> pel7o�m�ancono%lconslru�lon�T�vf7ani�n�ui/io odb��thoown�yo�h/s��nsfructionorlhe ;t �x . .., . <br /> �vork Por u•hrch applica(ron is made ond!c�mply wiU�1he Stnt�Cuntnctvrs�w f8 27 RCW and <br /> 296,Q00 N�AC. <br /> � � c.�a,.� r-�. 2310� <br /> S�9n�lure O�te — <br /> �k � ���' �%� �7��/7` <br />