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11/01/2010 16:23 FAX 425 377 1076 HEX ELECTRIC <br />Z 001 <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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 A81 TO 4 PM <br />05 <br />PROJECT ADDRESS <br />Owner Mail Addess City State/Zip Phona <br />Tfvl h u C�f GLi 4 ,3�4 S� �1a�re�+A�IMi wav <br />Tenant Mail Address City I StaleZp Phan <br />�6if �[&- -ri ,�jj O ;dc, (uiz($'"'I*N4. &I kt?5 W(�� &A 9Aa56'1 If-zZ-r7 <br />Electrical Contractor Mail Address City State/Zip Phone <br />i C�-PCELE_,5R IaZN L4 06 <br />tale License Number Contract Price of Work <br />�)CA,< 10'9; CeV+.e"r- <br />Proposed Use of Building —��}, Contact <br />/Person (Plan Review) <br />Description of Work to Be Done: t+. l� +c' TL LAni f f�S % (��Q•�Q e d �y <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 />I hereby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this type of work wifl be comoleted G' IU `\ , Q (J <br />whether specified hemin or not. The granting of a permit does notppresume to give authority to L <br />violate or cancel the pprovisions of any ofhersfote or local law regulating construction or the <br />performanceof consruction. That I am authorized by the ownorof thls pproperty to perform the <br />H ork f •r which application is made and I comply with the State Contra ors Low lS.27 RCW and <br />296.2W WAC. <br />Signature Dgle <br />