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FROM :Wieco Electric Oc o r FAX NO. :3606914838 1 Feb. 07 2011 06:34AM P1 <br />r• <br />_ ��rwrxn <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 8 AM TO 4 PM <br />_413� FbC0AL. ��E_ <br />PROJECT ADDRESS <br />leTweAc Ave-�E�it. cJA <br />Owner Mail Address City Statamp Phone <br />Tenant Mail Address City Stale/zip Phone <br />1EeL� �Le�l e�c �� t� C� . Bac s�Q *. ,Iyc 4AU, c�lA 9Kisa— <br />ElectricalContractor Mail Address City St3te/zlp 3��r_4Phone, <br />if3 y <br />qqq. <br />W l4 Cep = 13 <br />Slate License Number Contract Price of Work <br />R <br />Proposed Use of Bung Contact Person (Plan view) <br />Description of Work to Be Done: //!mac-t ci �7 /-���'^ — ya (�N,�.. O"" l.Jf4! . <br />i <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 />l 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 camplefed <br />whether speclfled herein or not. The granting of a permit does not erasume to give euthority to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />performance of construction. That l am authorized by the owner of this ropetty to perform the <br />work for wl ch application is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 <br />��-�--- 2- 7 i1 <br />L <br />Signature Date <br />