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08-07-'09 14:29 FBOM-nw permit 13609952091 T-604 P011/014 F-551 <br /> � � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8870 - FAX425-257-8857-vwvw,everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 4521 FOREST DR <br /> PROJECT ADDRE33 <br /> MIKE OGDEN 4521 FOREST DR Everett WA 98203 425-359-4136 <br /> Owner Mail Addreas Ciy Stata2iv Phone <br /> Tenanl Maii Adtlress Cily Stale2ip Pnone <br /> WESCO 2800 Thorndyke SEATTLE WA 98199 800•398-4663 <br /> Electrical Contfactor Mail Address City ' StateRip Phana <br /> WASHIES9710D ex 09/02/09 $1200.00 <br /> Stale License Number ConVsct Price of Work <br /> SFR <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> Description o1 Work to Be Done: <br /> Add/alter 2 cfrcuits for gas furnace install <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 9E IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7T LOCAL SALES TAX CODE IS 3105 <br /> I hsreby cerii/y U�at I have read and examined fhis application and know the samo to be frue and <br /> correct. All provisions o1laws and ordinances govsrning fhis type of work will be completetl <br /> whe�herspecified hsrein ornot. 7he granting ol a peimd tices notp resums fo give authw,ry fo <br /> violats o�canref the prov�sions of any other state or local law regu/eting conshuchon o!the <br /> perfomrance oI consiruc(ion. That 1 am authonzed by fhe owner of this property to perform!he <br /> work lor which apphcation is made and I compty with the State Contrac(ors Law 18.27 RGW and <br /> 296.200 l�'AC. <br /> �---, .` — � l� o �' �/ <br /> Sign� re Date /; �� <br /> �� �1b v <br />