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02/13/2013 14:12 4254897996 HOME RUN ELECTRIC PAGE 02/02 <br />t I, <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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />PROJECT ADDRESS <br />(-X Ce)9 PO Px�y.1`� kE�,w�Pr"t�lT <br />Owner Mail Address II City state/Zip Phone <br />ryA 5 Sw 4>_�er& <br />Tenant Mall Address City S te2ip Phone <br />Electrical Contradvrr� Mail 1Address City \ ^StalejziiL��a-S�O—I Phone� <br />V_� <br />State License Number y C1ontraM Price of <br />Work <br />Proposed Use of Building q Contact Person (Plan Review) <br />Description of Work to Be Done: GL[Jl �%(�C,t u + �%� Qy,�Y �� �,CSLr naa <br />�ri n, <br />11i�(L'u.liS �tt,� D P(r�lcrxX- I.�d�� h rIY1C�,r�`S d' Wrlvr�iS ���JYr <br />+(�i Cc fS <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />��ovo <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I Itereb certify that /have read and examtneof this application and know the same to be true and <br />co rect All �rov sions of laws and oN n nces govem n this type ofwork w /l be, completed q <br />whether spe6 herein ornot. The granting 0f a permit does not resume to give authority to L 13l%� D t a <br />violate or cancel the provistons of any otherslete orlocellaw reguPting construct on or the <br />performance o! consiructlon. That I am authorized by the owner ofthis property to perform the <br />work for which appItCatlon is made and I comply with the State Contracttors Law f8.27 RCW and <br />296.200 WAC. <br />Si ature Dale <br />