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12/21/2006 06:59 14256360964 AVIDEX PAGE 01 <br /> ELECTRI AL PERMIT APPLICATION <br /> CITY OF ERETT PERMIT S�RVICES <br /> 3200 CE AR STREET, EVERETT, Wn 98201 <br /> 425•257-0810 - FAX 425-257•88�7-ww�v,ev@retlwa.org <br /> APPLICATIO S ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 3003 w . C�s�NU P-� .f3��� �{0-58 <br /> PROJECTADDRESS <br /> P�-D�ir�s 3ao3 �..1, �No RD. �v�T� WF} 8�3 <br /> OWne� ldeilAdd.resa Cily Sta�E1L0 Phon,; <br /> TOnant Maii Atldress Ciry Stata2p Gpone <br /> STE���0 <br /> 1�E X ��sT —P--� , � <br /> Electncal(;Orl�raC:or Nall Addre73 Gty Slate/Z�p � Vhone <br /> �0�l3-o�sv <br /> � � aco 3e �S, or�o <br /> State LiCensa Number Contract Price ol Work <br /> ,.o vii�� PR-a�(� <br /> Proposed se o1 Building Contact Persnn (Plan Review) <br /> Uescnption o(Wark to Be Done: ,v`S (�.O�1p.7�_ �C�� P(L-C�(� '�',Z <br /> �J 3 w.f+-� "R� a-�� P�-A�E � � �'�c—tf (��M � <br /> NOTE: WIRING IPJ NON-DWELLINOS IS RE UIRED 70 FEE <br /> BE tN RACEWAYS,MC OR�C CABL <br /> CITY OF EVERE77 LnCqL SALES TA%CODE IS 105 <br /> I here4y cedrly that I have reaU an0 srarnined fh�s a qlicetron and know tho same fo be We arid <br /> cotrecl. AI!prows�ons o�lews and wdinancos�o�e� mg this type ol work will be rompleted <br /> whofho�speafiad IrBre(n or nof 7'he gr.�nryng ol e p rnuf dces nctp�esume fo grve aufhoriry(o <br /> v�olaf9 vr cancel the provimoqs olony ofher state or Cal lew rngu/atinp consfnic(!on or fho <br /> pedormance o/construchon. That I Bm eufhu�ized the owner o/th�s property to pedonn fhe <br /> work Ior Which applrcation�s matle end I comply�vif fhe Stete Confroctors Lavi id 27 RCW enrl <br /> 2P6^ AC. <br /> 1Z l�j <br /> �g�aNre e <br />