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09/15/2008 12:06 4254885288 PAGE 01/01 <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 — vrvnv.everettwa.crg i <br />ef— 0g09-010 <br />APPLICATIONS ARE ACCEPTED FROM A AM TO 4 PM <br />JD5 ` cE r7.ti1'zSLESY lyun, ,wll �Z) <br />PROJECT ADDRESS <br />I-?fo-t z f7VF'L^ Lt-G 17-gli 0C-. %r4 R�VO -M P1 ti C1T1( C't' CiiaOY <br />OWnef Mail Addrnss Cl1) StaterZlp Phone <br />•r11G orAWA-VAGA- 42-v— <br />L014,0-MH w,or-) �jDr7 Se fug -Tr I ru. wti-( 1 WA- limy iS"- <br />Tenant Mail Address City SlatelZlp 253 Phone <br />1i7'T[�earr1 SerVr�c� 110?t r%• iPecitz-fuLuxdir1f;y �tk� 4r^ itoi/ 3�7 -II`Sr <br />FectricalContractor Mall Address City Statcop Phone <br />�\ Gc$'LV7ZiJS 11,OU•00 <br />State License Number Contract Price of Work <br />Proposed Use of Building (� Contact Person (Plan Rrview) <br />Description of Work to Be Done: cGf �tycryTl� �E<'A2t"I `'t[SZ" eow�Y�u' r>M tZ <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO F[I <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />1 hereby certify that I have read and examined this application and know file same to be true and <br />correct. All provisions of laws and ordinances governing this "of work will be completed <br />whetherspecified harem or not. The granting or a permit does not presume to give authority to <br />violate or cancel the pprovlalons of aqv other?late or local law regulating consiruc.ron or the <br />peniormence of cons trucilo . That 1 am suthcracd by the ownerol this property to portbrm the <br />work <br />for <br />which <br />C application fs made and I comply with the State Contractors Law 18.27 RCIV and <br />9-/> •o y <br />Signature Date <br />