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09/26/2011 21:14 253--665-5199 FEDEX OFFICE ( 5506 PAGE 03 <br /> l l <br /> ELECYRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320U CEDAR STREET, EVERETT, WA 98201 p a���' <br /> 425-257-881q - FAX425-257-8857-www.everettwa.org I `' <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM CI I D I `��� <br /> �U33U Eue�r�n �Ja� SN�� I� <br /> PROJECT ADDRES9' <br /> pw,per M6il AdWpse Ciry Stete(Llp Phone <br /> (S� IU33t F.xx,r�., Wr �•:� r Gl�l°�� �'�77'7 /O�n`'U1 ��' `�' II_l� <br /> �"rrmrrs �ti�s5 �. ��---�-- G state2p Pnone <br /> Tenent Mal Address �Y <br /> N1e�-ro CI��', 'w ���3 ��F�.� � alc�; �,L� i�A 95134 a53-3o'i-SSoS <br /> Electrical Contraclor Mail Addreas ��ty S�ate'f�P Ph°"a <br /> mCTRo L !�l C�i� _ � �� � ' � <br /> State License Number Co�Aract Price of Wwk <br /> �e�'a,l ��5� ?�mh,��S <br /> Proposed Use af 8uilding Contaet Persan (Plan Review) <br /> DeSCription of Work to Be Done: � ' �S� C�� � e�� ���' "'�� ��� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 5v. vv <br /> CITY OF EVERkTT 40CAL SALES TAX CODE IS 3105 <br /> 1 he�eby certify that 1 have read end examined this appllcetion and Imow tl�e same to be frue and <br /> corYect. All provisions of laws and wdinences goveming ihis type af work will be tompletetl <br /> whether speclfr d herefn or not fie 9ranting of e pertmt does notpresume to give authonry to <br /> violeteorcan 11he p�ov+sron anyothersfateorlocellewregulatingcronshucdonwthe <br /> peArnm ce consYnictlon. het I am authorized by the owner of this property fo perform H�e <br /> werk hic applicetion is ade and I Comply with fhe Stete Conhacfors Law 18.27 RCW arM � <br /> 7962 VI'A . <br /> - �,-a� - �f �� � - � <br /> 5���� � <br />