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07/27/2007 10:57 3606598578 NORTHERN LIGHT ELECT P�GE 01 <br />- � ! <br />EL�CTRiC�L PERM��" APP��CATION <br />CITY OF EV���TT PERIVIrT SERVICES <br />3200 CEDAR STREET, �VERETT, WA 98201 <br />425�257-8810 - FAX 425-257-8857 -� wuvw.everetlwa.org <br />APPL.ICATfONS ARE ACG�PTED �ROM 8 AM TO 4 PM <br />/ � � T 1/� ,t�r <br />Pl�OJECT ADDR�SS <br />r <br />�,1 ������� <br />OWn�r Mail Addresa T.��.... Clty ..,. state2ip ..... Phone <br />Ter��nt <br />E{ectrical Conkractor <br />State �icec�se Number <br />Proposed Use of Bullding <br />Description af Work to Be pone: <br />Maii Address <br />;�� ,�� �. � <br />Mai! Address <br />City <br />Cl2y <br />fi`tfi� 8/�Y' <br />NOTE: WIRING IN NON-DWELLlNGS iS R�QUIRED 70 <br />BE fN RAC�WAYS, MC OR AC CABLE. � <br />CI'TY OF E1/�RE7T LOCAL SALES TAX C�DE IS 3't05 <br />State/Zip <br />State2ip <br />Contr�ct PriCe of Work <br />Contsct Person {Pian �eYiew) <br />I hereby Certify fhaf ! have read �nd examined rhlS appllCAtrOrl and know fhe same t0 be tlue and <br />correcf Al/ provlsPans of /as�vs and ordlnances goveming th/s fyp� of work will be complefed <br />whethar speclfleU h@rein or not. The gr&nfing of a perm�2 does nOt pr'osume to give euthorlfy fo <br />v1o/ate or canco/ the prov/slons of arry oiher state or loca/ !aw regulating consFructlan oC fhe <br />perforrnance of constructlon. That 1 arn authorized by the owner of fhls roperty fo perform the <br />work for whlch appllcatlon �s macie and 1 compCy with the 5taie Contrac�rs Law 18.2i RCW and <br />296.200 WAC. <br />��� <br />Phone <br />Phone <br />