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05/15/2013 14:56 rAX 42535389. <br />Evergreen SecurltF <br />Q 002 <br />cc,C �S' 3 n <br />D <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - w wv-everattwa.org <br />APPUCATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS /�-� <br />�e L c m��.��1 >V+Gjve Ali' tA5)0t- �t n <br />91I <br />Owner -� Mail Address City State2lp �- Pnmo <br />�y 2cchtN d GlR llcr �! Zq 1(� ^ , t.51�+ �18263 (42-S) 5 <br />Tenant Mail Address d Slater2IP Phone <br />rCrc�tetm ��utf,6., 4 l)S-arD-d,.Xi , !�(�� G—•,e.e,H I'-)z� ,i-a 3'f8 3 <br />Electrical ontfactor ai' Atldrass Ciy StateOp Phone <br />G9 — l 310. �o <br />State License Number Contract Price of Work <br />Proposed Use of Budding Contact <br />Person <br />�(Plan <br />^Review) <br />Description of Work to Be Done _ —Sv A 1 '( I ?) O r f, -) <br />^-ry <br />NOTE. WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. 50 Q6 <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />/ hereby certify that I have read and examined this application and know the same to be true and <br />correct All provisions of laws and ordinances governing this type of work will be completed Oq <br />whether specified herein or not. The granting of a pound door not pTsume to givo authority to <br />violate or cancel the previsions of any other state or local law regu pting constnrcf/on or the <br />performance of consWciion. That I am aulhonzed by the owner of this pproperty to perform the <br />work for which application is made and I comply will? the State Control: re Law 18.27 RCW and <br />296.200 <br />Signatum Date <br />so <br />