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Oc t. 5. 2012 7: OOAN No. 5365 P. 3 <br /> � � <br /> EL.ECTRICAL PERMIT APPLICATION <br /> f:ITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 88201 . <br /> 425-257-8810 - �AX A25-257-8857 —wuvw.everettwa.ofg <br /> APPI.ICATIONS ARB ACCEPTED FROM 8 AM TO 4 PM <br /> I�l�6 l.o,whard. Ev ag201 <br /> PROJECT ADDRESS <br /> ��rv^cL E`!50� savv� N z5 Z�b�39 <br /> OWnef I MdilAddrec6 CIly Slate2lp Phone <br /> 79n8nt MeilAddr¢se Cily SlelelZip Phone <br /> c� m u��r,a ��15 8►�d�,.v C e�� WA 982D I �25 25q t���� <br /> Electrical Contracto� � Meil Addresa -T Cily Slale/Zlp Phone <br /> Cm�4 AMNq01(�R _ �D� � <br /> Slate Litense Number Conlract Price of Wo� <br /> Proposed Use of 8uilding Contact Person (Plan Review) <br /> Description of Work to Be Done: 1 e✓ • Q� ��� N 1''�� <br /> V1�W � S�i.. <br /> N07c: WIRING IN NO(J-D�NELLINGS IS REG�UIRED TO ��� �,,l <br /> BE IN RACEWAYS, MC OR AC CABLE. �a v v <br /> U <br /> CITY OF FVERET7 LOCAL SALES 7AX CODE IS 3706 <br /> I hereby ce plly thet I Nave ree 'and examined this application and know the same to be fnie and �� '� O I 2 C� <br /> correct. AI! rovisions oilaws and orrlinances goveming fhis fype of work wlll bo complefed 7 J <br /> whnfher speci(ed lierein or not. The granting ol a perm�t dovs�of presume to plve eufhonfy fo <br /> violate or cancel the provisions of eny Otherslete or local law repWating consfiuction or fhe <br /> per/ormance of COnstroc6on. That l arn euthonzed by the owner of this property[o peAorm the <br /> work Por�vhich eppfication Is made end 1 co:nply wifh the State Contractors Law 78.27 RCW and <br /> 296.200 WAC. <br /> .. I���J��� <br /> � Sign�tur9 Dale <br />