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, <br /> O1/10/2G11 HON 16: 23 PAX 4256203487 GreenWoOd Heating 6 A/C m092/002 <br /> i <br /> ELECTRICAL PERMIT APPLICA�ION <br /> CITY C � EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREcT, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> Llb�o Evcrc�rce,� w� �e1 <br /> PROJECT ADDRESS <br /> '� �lblo kxu, sk.,� C�e�e�ltiW �1�03 �I2s��5 . i6 <br /> Owner h7allAddress Clty , SWIe/Zip Phone <br /> �A YYb <br /> Tenanl MailAddress Ciry Slatc+l.'_ip Phone <br /> �,s �la�. w;sh - or4�� �32� �ct�� �r ��c�m� ,��� �a� ar��-��� s <br /> ElectdcalConl�aclor � MailAddress Clry � Slate2ip Phono <br /> �-1SVnk.�Jw�25 tJm a�� <br /> Slala License Num6er . CaMract Price of Woiic <br /> D��� San� M�c��e� <br /> Proposed Use of Buildin� Contact Person (Plan Review) <br /> Descriplion o(Work to Be Dane: ��Y l.C.lni` `fi� � N'\�— � � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby cerlily that 1 hava rend and examinod this applicafion and know Ih�same to Ge true and - <br /> coiroct. All provislons of laws and ordinances goveming this typo of work will be,completed <br /> whethor specified harein or noL Tho gran(ing o/a penmt doos not presume(o g�vo authonty fo <br /> violafe or cancel Ihe provisions o/any ofher stafo or local law regulatin�consfrvction or fbe <br /> pedonnance o(construction. That I am aufhonzed by fhe otmer of Ihis propeRy fo peAorm lhe <br /> work lor which applicafion is mode and I comply wi0r the Stato Conlractors Law 16.27 RCW and / , 0 2 1 <br /> zy�..00 wA�. �il d � �r�— <br /> 'gnat re Date <br />