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Jun.23. 2009 8:1:)AM light Doctor No.4512 P. 4 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES �q <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425.257.8810 - FAX 425-257-8857 — wvvw.everettvia.org <br />APPL!C•A110NS ARE ACCEPTED FROM 8 AM TO 4 PM L <br />zi zi MoAison <br />PROJECTADDRESS <br />D D S S a �r n e O,S a..lo \I t <br />Owner MalIA draoo City SlaloRlp Phone <br />Tenant Mall Address City Stala0p Phone <br />Electrical ontraclor Mail Address City Stale/Zip 901:J7 Phone <br />T Dl 9 54 LSD 1,y <br />Stale License Number Contract Price of Work <br />Proposed Usti of Building Contact Person (Plan invievi) <br />PlaReview) `1 <br />\_I ,IL <br />Description of Work to Se Done: �l 1�� ek r-izki \ <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 I <br />I hereby certify that I hate read and examined Oils application and know the some to be true and � <br />correct. All provisions of laws and ordinances governing ibis typo of work will be completed C ofkov - l01 <br />whothor spocihed herein or not. The granting of a permit dons not p resume to give authority to <br />violate of cancel the provisions of any other state or local law ragulaling construction or the <br />performance of construction. That lam outhorizod by the ot•.nor of Ons property to perform the <br />work for which application Is made and I comply with the State Contractors Low 18.27 RC4V end <br />296.200 WAG <br />-���� / i�Ualp I <br />