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OCT-07-2012 18:09 From: <br />To:2578857 <br />Page: 111 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 (0 <br />425-257-8810 - FAX 425-257-8857 -- wwvj.everettwa.or9 C 2 10 -05I <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3D 11 rQY3ye nub <br />PROJECT ADDRESS <br />Owner - <br />Mail Address <br />City <br />Slate/zip Pnone <br />73 cLl <br />Tenant <br />Mai A✓ ddress <br />City <br />Staiezp Pncno <br />6&�fo►L <br />�������1��- <br />w ���o► 23�� <br />Eloetncat Contractor <br />Mail Addrass <br />City <br />Slate/Zip P: ooc <br />50➢Uzf p 1 gl)7 <br />3� <br />State License Number <br />Contract Price of Work <br />Qn �� <br />b_ <br />\ <br />Proposed Use of Building <br />Co taet�Parssull (Plan Raviev:) <br />Description of Work to Be Done: <br />I(�/��7 <br />, �� UO I �}C. <br />< 1)4_y <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE 1;3' )5 <br />1 hereby ccrtily Thar I have read and examinod this application and know the same to be true and <br />correct. All provisions or laws and ordinances govorr rig this type of walk will be completed <br />whether specified herein or not. The granting of a po, mif does not resume to give authority to <br />violate or cancel the provisions of any other state or kteal law regulatlnq constriction or the <br />perfomldnce of construction. That I am authorized b, the owner of thls ropeny to perform the <br />work for which application is made and I comply tsitt, the Slate Contractors Law 18,27 RCw and <br />1)'�Sipnffiure / (� Pl- 1� uato y cu-eQ " a5 �! .� <br />FEE r�0V <br />J <br />