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O1/20/2012 FRI 13: 11 �AX 425 378 7045 WA Nuturnl Cas 1�009/OOS <br /> � � <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-ww�v.everettwa.org r y.a�� 2 <br /> APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM ���(�0�� <br /> IQ�2h �a�Q��ta"(o„�Q.�' 1�n91�. 98� <br /> PROJECT ADDRESS <br /> �25-5/�{-9822 <br /> �o� Wlaallg 52D (�a,�Qu,�tX�. ��/Pilk� ll��- �18Z�, : <br /> � Owner Mail Addreu City StatelLF Phone <br /> Tenanl Matl Address ���Y S���N �0� <br /> � o �M � ��raQ �'n�. ZL��Vf (�a�a1V�b�1�7� �i✓�u�( Y�� 982�f �Z5-3N7-I�f1�F <br /> Elad�ical Cor ractof Mall Address City StalelZlp Phone <br /> A�t QooQF �u�2 41�q�7R � 3430 .�b <br /> State Ltcense umbor Contrad Pflce of Work <br /> � • <br /> 4�sw.u. �a,w�A �,W�w� '�o-g��n�.�aQ. l�.t.(d� �25 •3�7-1�j1� . <br /> Proposed Use of Build g Conlact Person (Plan Review) <br /> DescriPtion of Work to Be Done: y,,y�y^'�$"�^q � � R `�"� �/-� '�"lA��2A��� <br /> J <br /> NOTE: WIRING IN NON-DW ELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. ,Q � <br /> . ��, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � � ? g� <br /> I hereby certify that l have read and eaamined this appfication and know the same!o be frue and � <br /> correct. All provislons o//aws and ordlnances yoveming fhls type o/work will be complefed � _ v(D"� <br /> whether specltied herein or not The granfing o(a perm7f does not presume fo give authority to �� 2C� <br /> v/o7afe or cance!the provlslons o/any ofher sfate or loca!law regulating constructlon or the <br /> peAormance o/construction. Thet I am authorized bylhe owner of fhls property to perform the <br /> work for whlch application is made and I comply with fhe State Conhac(ors Law 18.27 RC W and <br /> 296.200 WAC. _ <br /> I 2d �Z <br /> . gn u Da e <br />