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06/06/2005 10:53 FAX 3608481072 COMMERCI.4LFIRE Q 001 <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 — wvnrl.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />91^ <br />6I <br />y_ <br />lW' \ I1 lAl� <br />PROJECT ADDRESS Lk) <br />rvrnrdi RR I I `0510 w E w4u.lo 'Ak>J,!✓al # 120 <br />Owner Mail Address City Slaleklp Phone <br />Tenant Mail AddressSta�l�ej2y <br />�� <br />I%� `�q Gp '��P�hJ%oCn�e <br />( �(�1►'Y al' 0j fl1 rr�m 4il/ V� 1� IY lJU! �I k 1 11 l Q 1 l Oot r `-> <br />Electdcal Contractor Mall Address City state/zip Phone <br />������►3Z� 18 3L <br />State License Number Contract Price of Work <br />�eAOA )i Sc ~i ica►Y1 Y--) <br />Proposed Use of Building Contact Person (Plan Review) <br />(( ���, 1 <br />Description of Work to Be Done:( Off, .04CL l/ fi w .!?�'� 1c +� �,-tl k (. ,,��day n fa/ <br />V tr <br />M-r, ' �1 �/1t�t' Ai/.rPla .n� P inyRw�j t> w I /lw Ii, 94P n ZOA t A i <br />i 1 <br />dii. 0.1(A ''frl <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. /Q/j pJf <br />/ T <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that 1 have read and examined this application and know the same to be In re a _ <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />��tv <br />whether specified herein or not. The granting of a permit does not presume to give aulhority to <br />violate or cancel the provisions of any other state or local law regulating conshuaion or the <br />perlo of construction. That I am authorized by the owner of this roperty to perform the <br />r whi application is made and I comply with the State Contracferse Law 18.27 RCW an <br />96.200 WA <br />/ <br />t XI 1y <br />Gs <br />� <br />Signature <br />1:50506 03� 3l`�' L1�� ��a <br />