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AUG-�4-2�09 c0:15 From: To:2576657 Paee:l�l <br />� <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />,:1' 3200 CEDAR S7REET [VERETT WA 90201 <br />� 425-257-8810 - FAX 425-257-t3857 — www.everettwa.org �`- s—� <br />APPLICATIONS ARE ACCGPTED FROM 8 AM TO 4 PM E" �� �g �(7 <br />�a�3 ar" � <br />PROJECT ADDRESS <br />OwnP.f <br />enant <br />[IeCtriCal Conlractor <br />Mall Address <br />----`�-'"c <br />Mall Atldr2S6 <br />iC � � I <br />Mali Addras6 <br />so�z i P ��i��'D7 <br />State License Number <br />�7"�1,� „ <br />Froposed Use of Building <br />L► <br />Cily <br />Cib <br />Slale2ip Phona <br />Stale/Zip PhonO <br />� <br />Clly Stale/Zip Phonc <br />�, `�1 I S" <br />Conlrar.l Price Of Work <br />.5h�-�'�' <br />Co I3Ct?erson (PlanRoviuw) <br />NOTE: WIRING IN NON-OWEILINGS IS REQUIRED 70 FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCl1L SAL�S TAX CODL IS 3705 <br />work <br />19G; <br />y coAily (hat I have reed and exnntined this applicafion and know the same fo be Irue and <br />. All provrsions of lows and oniinances govaming this (ype ol work will bo complefeA <br />r spr�cifind hereln or nof. The pranling ol a pannrt does not resume lo giva authonry to <br />or cancr.l Jhe provisions oI ony otharsfafe orlocallaw repuPatinq consGucGon or tho <br />�anc� of construction. Tha! 1 om Auibonze0 by the ati•ner cf fhis prcperiy fo pedorm the <br />�r whrch appllcation Is made nnd ! compty wifh (ho 5(ate Con(racfors Law 18.2� RC W and <br />y OI(�II:IIWC / �r �� � �� <br />QI�°�1,� C� 4 ^ G7 <br />�9 <br />�c�5o�--a�7 <br />�,, ��,,�- �yr''°�'`�: <br />�1`� <br />