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NOV-15-2011 TUE 09;18 AM Prime Electric FAX N0, 4257475552 P, 01/01 <br />�LECTRICAL� PERM�T APP�.ICAT�ON <br />C�TY OF EVERETT P�RMIT' SE�RVIC�S <br />3200 CEDAR STRE�T, �VER�.TT, WA 98201 <br />425-257�8810 - FAX 425-257-8857 -- www.everEttwa.org <br />APP�ICATIONS ARE ACCEPT�D FROM 8 AM TO � PM <br />►����-�-`/���-����f� ��l� <br />� � � <br />f ����� <br />�� <br />rY , ��� � <br />PROJECT ADDR�SS � <br />�z�: <br />� _ . . _ � .,.,���� � �� r- , ., � -�� � �/'������ 2Y�}����" <br />ef <br />11 <br />Tena <br />Mail Address <br />// <br />Mail Address <br />ElecCrical Contractar / Mail Addres6 <br />� � ��/� . l <br />State �icense Nymber <br />r <br />Propose Use of Sudd ng <br />^ <br />pescription of Work to Bo pone: <br />NOTE: WIRING IN NON�DW��LINGS IS RE(�UIRED TO <br />BE IN RAC�WAYS, MC OF2 AC CABL� . <br />CITY OF �V�RETT I.00AR SALES TAX COpE IS 3105 <br />City <br />1� <br />C11Y <br />l� <br />State/zip <br />r <br />Glry � � Statalzlp �'hona <br />� <br />Conirac Pri e a W � <br />,� <br />Contact Person (Plan Review <br />C�f���'���'�� <br />�-, � � l. fy`r <br />I hereby certify that ! have read and oxamined this applicstion and know the sAme to bo tr'ue and <br />correct. AN provr'sions of laws and ordinances govemin this type of work wfN be complefed <br />whefhor specifivd herein or nof. The granlrng of a perm�`r aoEs nor presumo to give authorlty fo <br />violate or cancel tNe �rov/sions of any ofher sfaie or loc�1 !aw rogulating construction or the <br />performance of construction, Thaf l sm authorizad by ihe owner of this property to perf'orm the <br />work for whrch applicstion is�de�nd l�mply wi the Stato Confracto� Law 9�7 RCW and <br />296,200 WAC�s� ___ / / // <br />,� �. <br />���,� . . <br />, <br />� �_._ <br />%/� _ <br />� � �✓i <br />��E <br />- 7� �� <br />�� <br />///��9� <br />, <br />G <br />