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09i28/2011 19:J4 FAE 425JSJ89J4 ErerBreen Securit� �002 <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> ClTY OF EVERETT �ERMIT SERVICES lzg�i� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 �/ <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org Ejjo9�(� <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> �l I '�rc�td,�xi.�.1 � � <br /> PRO.►eCT ADDRESS <br /> Owner M�II AeGiecr Giy State2' hnne <br /> IIS�l�.�ht�,t�►'I�s �1l '���/_'�����-�{�—C� �v�e�-�- �UA-q�?,ol��� <br /> Tenant MaIIAdAracc \dlfy StaterZi h <br /> . � Zs�34 -��D <br /> �I/Y_L�F �(JS��xi�c�'',uA.S'�i.i�P. 101 �� c.�} ��� <br /> Ele IContractor eIIAEdrow I�i—� State2lp Phona <br /> CVLR.6�S_„L.l I a La � �I l�D.��° <br /> Stafe Licenre Number ContraM Price ot Work <br /> �AtY1tY1LYGi2� ��� Mu.rr <br /> Proposed Usc of Building Contad Person (Plan Review) <br /> DescripUon of Work to se Done; (.�('i1/lJ V v � "f�(1�1c _ � 1"]"� 1rM1 T�'� � � <br /> �R- � � S- <br /> NOTE: WIRING IN NON-DINELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SAIES TAX CODE IS�105 <br /> 1 hereby ceRify fhat I havB read and examined this applicetion and know fhe same to be GUe arM <br /> crorrecG AIl provisions of laws and orcllnances goveming fhis ty,�e o/wortc wiil be eompleted <br /> whefher specifietl herein ornot. Tha granGng oI a permrt does nof presume to gi�^e au[hority to <br /> vlo/efe or cancel fhe pravisions olany other stafe orlocal!aw regu/eting constrodron or ihe n <br /> peAomlaCC6 of GbnsWcfion. That I em authorizad by fhe owner ol fhis p�o�rty fo pBIloR71 fhe � <br /> work for which applicafron is mave and I�ompty wifh fhe Steta Contractors Caw 18.27 RCV✓and <br /> 296.200 WAC. /�D n i � <br /> y <br /> Slpnature Date <br />