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NOV/01/2012/THU 10:13 AM BelRedElectriC FAX No.425885iR65 P.002 <br />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 - wvAv.everethva.org OLIY <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />44 7-4- 6-LJ;,4 RAV N Dktvti <br />PROJECT ADDRESS <br />SAT4vy 14TrrY(ii"E> 4'724^ c.ct" KAvulu ()Rt✓ Evn4riT, (c'�i 4Yza3 <br />Owner hlailAddres3 City State/Zip Phone <br />Tenant Mail Address City Slate/Zip Phonv <br />00-L•c41-0 e4,"M(c SintucF_ �lo B 3�2/ r2dM�o+Yd l✓� g8o73 3YL( �� 883 ll?� <br />Electrical Contractor Nail Address City state2lp Phone <br />)t6LR7- Z f-1 Z - <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Walk to Be Done: N ra... doe, " r- t2e V/ (S A.+Y f ve 0 r s�op,K <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, NIC OR AC CABLE. ol�o <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and examined this application and know the same to be true and I Z' I O O <br />wrrsct All provisions of laws and ordmanuas govonvrg this type or work will be completed <br />whether specified herein or notThe granting of a permit does not resume to give authority to <br />.violate orcancel the provisions of any other state critical law rvgu/ating construction or the <br />performanco of construction. That I am authorized by the owner of this property to pelfomm file <br />work far :high application is nmado and I complywith the State Contractors Law 18.27 RCW and <br />290.200 AC. <br />7 •! <br />atura Date <br />