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07/26/2007 10:26 4255622866 LANDER ELECTRIC PAGE �1/01 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERET7 PERItilIT SERVICES 7-a6--b7 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 i 7D7-16� <br /> 425-257-6810 - FAX 425-257-8857—www,everettwa.org � <br /> APPIICATIONS AR6 ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CA{tDS ARE NOT ACCEPTED <br /> 6512 � Ilioff' 11� � � <br /> PROJECT A�DRESS <br /> 25 <br /> Dqn �N9 ► £ 65� 2 C iiiott W�r Cver�tt WA� � S�o3 3�g-���� <br /> Owner Mail Add�ess Clly Slole/Zlp Phone <br /> N/ �} <br /> Tenant Ma0 Adaress Clry Slata2lp Phone <br /> Y'2> -562 -i 7 71 <br /> L��ride�r � I �ctr � c �ehvice, � lc. 1335� NE ibth St• �ellevue WA <br /> Eleclncal Contractor A eil Addrnss � � Clry StelNZip � Phene <br /> I. ANDEE S� `� IG� ��-900.00 <br /> Slate Litense Number Conlr� act Price of Work <br /> �ihql� �qMily �eSio�ent <br /> Propose Use of Building � Contact Person (Plan Review) <br /> Descriptfon o(Work lo Be Dona; G�����_Pq j�e� , m et e h h q S� `I mq St �ePl�cemenfi <br /> T— <br /> NOTE: WIRING IN NON.DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> 55• 00 <br /> CI7Y OF EVERETT LOCAL S�LES TAX CObE�3 3105 • <br /> !here6y c�rtily thaf I have read and examined this application and know fhe seme fo bo true and <br /> Correcl. All p(Ovisions of laws and ordinances goveming fhis rype ol�vork will be Co/np/ated <br /> whethar SpeCdied heroiq ornoL The granfing ot e pormd does not rnsumo to give eufhonty to <br /> violate or esncellhe provisions ol any other sfate orincal few mgu�ting construction or the <br /> peNormance ol construclion. Ataf I am authonzed Dy tho o�vner oflhis proparty to peilorm fho <br /> work lor which npplicafi0n is m�do and I Comply with U�e SfAte ConfraCtors La�v 1B.27 RCW and <br /> 296.200 WAC. <br /> � ��°16 / 07 <br /> � Signalure Da�e — <br /> �crl Gl � l(o�-/ <br />