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10/13/2010 09:24 FAR 42595989J4 Gver6reen Seciirit9 �001/001 <br /> \ �, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PE9ZCIAtT SERVICES <br /> 3200 CEDAR STREET, EVEREIT, WA 98201 <br /> 425-257-8810 - FAX 425-257-985)—www.everettwa.org /0 ` �3�O <br /> ! <br /> APPLICATIONS ARE ACCBPTED FROM 8 AM Tp 4 PM �fo/O��2 <br /> / <br /> '�$35 C�2�,t2Eo� V�IA-� <br /> PROJECT ApDRE55 <br /> Owner Me0 Addmss r,ity Stete/IJp Pnone <br /> �" 1�'-�wR� ��3s �v���2�w►�ii c-t�r 4��3 <br /> Tenard A�ail Aqdress Clly —�StetelZlp Phene <br /> �-S 3�,g_ <br /> �il�12laR.�N aec.�ru���s t3Q�wA'y �lo�� �/fi �n1�9- U�a3 3�5� <br /> Electrical C.ontractor Mall Aedreca Cny Sutelzv Phone <br /> L-���s�t�a�a <br /> Slate Lice�se Number ContraCt Prlce ot Work <br /> ►��� La� KY�� <br /> Proposed Use af euilding Contect Person (Plan RevieW) <br /> DescripUon of Work to Be Done; I�Q/ V�� ����� J�(�(/li��-1. <br /> �NS�� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIREDTO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. j�' �O� <br /> ��-r <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> I here6y cerSfy that I have read and examined this application and know the same to be we and �� <br /> Con'eCL All prpVia7Dns oflaws ahd ordinan�es goVeming lhis typB of work will be eompleted f, <br /> whether sp�cified herein or not ihe grantlnp o/a perm�t does not esume fo piva authoNry to �V <br /> violafeorcrinceltheprovlsionsofanyofhersfatew/oeellawregu�ngcronstruchonorthe D I D <br /> pe�formance ol conairuc5on. That I am authwized by ths owner of thisproperty fo perform the / I <br /> vrork tor which appllcation is made and!comply wi�h fhe Stafe Contrac(ors Law 18.27 RCW and '/ <br /> 296.200 WAC. / � <br /> � � �0�13��.oro <br /> nature (�i D9te <br />