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MRR-21-2005 09:45 FROM: T0:14252578857 P.2 <br /> � �p <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SER�/ILES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM • DEBIT&CREDIT CARDS ARE NOT ACCEPTED <br /> ( l O lo �F-� b�-f- r4tJ�. <br /> PROJECT ADDRESS <br /> �PG -TF?6 rl Vt�d1� I(�(o �'�(�-�.. �'�C.t7./rZ�'�W1¢�( 4��fi7s''z�O29 <br /> Owner Meii Addreee Clry SlalefZip Phone <br /> V�N/�GJ <br /> Tenant MailAddres9 City SWl�lp Phone <br /> ��1 �y �I�o� ZBao�t�i�d.�lr� �Ps�K� 9�t Y9 <br /> ElectriCalCont2ctor MailAddrcss CI Stale/Zip Phone <br /> uJRfH/Esq� / aD t�S7J� — <br /> Stete Llcense Number Contract Pcice of Work <br /> S�2- <br /> Proposed Use of Building Conlact Pe�son (Plan Review) <br /> Descrfptlan oP Wark to Be Done: Q C�� I h� � l S Q y�p C(�G(i r f ��' <br /> Y�p �I�4ce. Z�lo (� <br /> NOTE: WIRING IN NON•DWELLINGS IS REDUIRED TO FEE <br /> B[ IN RACEWAYS, MC OR AC CABIE. <br /> CITY OF EVERElT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf I heve read and ezamined Ihls applicafion and know Ihe same fo be frue and <br /> correct. Afl provisions o/(aws end ardinences goveminp fhls type ol work will 6e camplefed <br /> whether spedfied he2in or nof. The grenfing of a permd does not prasume to give aufhonty fo <br /> violafe or cencel fhe provisions ol any ofher sfafe or loeal lew regu/ating constructlon ar tbe <br /> performance o/consfrucfion. That 1 am authonzed 6y the owner o/this property to peAorm the <br /> work lor which epplication is made and!comply wdh the Sfafe Contrac(o�s Law 1R.27 RCW and <br /> 296.200 WAC. <br /> w�cQ� `� 3�zc a <br /> 5 gnature Oate <br /> � OS0.3-0'�l <br />