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06/1,7/2008 08:53 4254885288 PAGE 01/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 L `77` DCJ <br />425-257-8810 - FAX 425-257-8857 — mmevereltvva.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 0906 <br />PROJECTADDRESS <br />vmer `TJk a7i'hk.13& City Statemp Phone <br />�i4,.11c Dr- h.UvFi2.t G4— ADO <br />q-nvt. CSP�'16 .U...4.�;.° LAINoG> t-l0"L S£ rtvtz.- Vjtrtj Lf35 2_Z"N?' <br />Tenant N.r=,:,d.'e69 City State/Zip Phone X' Z <br />a53 <br />f}t7; �cccr~rr� S=JtC-C� 1102g1J. cP.tw¢nxov. ✓j_'iN - !'.T,fw. V+ %16rf/ 3"r7 -I11 <br />Electrical Contractor Mail Address City [ Statemp Phone <br />r�7i �5�9i3Zi7S _`r 000•oz:� <br />State Llcense Number Co itract Price of Work <br />Proposed Use of Building rlontsot Person (Plan Review) <br />Description of Work to Be Done: /AjMt t- jew ee-7-V C�Rr.G�r2A•r //DO - UP 41ei7`b J T $e751%t r� <br />S `v2 P J 4T-m- rl/2Q- H vet_ 6 xrsnN4) 5xEL"egy 9�c <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 hom certify that I have read and examined fhls application and know the some to be true and <br />correcty All provisions of laws and ordinances goveminj this type of work will be completed <br />whether specified herein or not. The granting of a permit does not presume to give authority to <br />violate or canal the provisions of any other state or local law iegulating construction or the <br />peRornrance of construction. That/ am oufhodzed by the owner of this property to perform the <br />work for which application is made and I comply with the State ContractorsLaw 18.2I RCW and <br />298.200 WAC. <br />1 =^ <br />Signature Data <br />D?' <br />