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01/08/2009 11:31 2062847716 <br />ASG <br />PAGE 02 <br />ELECTRICAL PERMIT APPLIC*ATION <br />A . <br />- <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREEY, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwe.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7000 HAP-DESON 42oAo mpo*t" opreft-l-lill BASLr <br />PROJECT ADDRESS <br />Commupirry TRA1asr 710o Wpazimo R Etiggpir W A 98203 425-341- '710 <br />Owner Mall Address city Staleimp <br />Phori - a' <br />Tenant Mall Address art) <br />. 1505 W ft *.r L.A*AL Ave N. STra, $20 <br />Aptoij so AjSr=C'0P-r7rf (Sria VAME.aemE WA IN(CR <br />Electrical Contractor Mall Address city staterzip <br />Phorii* <br />A Ro&js(;.-G- arac ce <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: a �Wa%W Lo%-) VOI-T-A&F- 51ECA)AIT-f 5'f.5T /n- <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN PACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br />c) �"4- <br />I hereby certify that I have read and examined this application and know the same to be true and l�-Zqc)l <br />corned. All provisions allows and ordinances governing this type of work wifl be completed <br />whether specified herein or not. The granting otapenn'tdoes not presume to give authority to <br />violate or cancel the rov.'slons of any other state or local law regulating construction or the <br />rmanceofconspruction. That I am authorized by, the owner of thisgoperly to perform the <br />performance R <br />for is I the IS.27 RCWand <br />work which application made and comply Kith State Contract ors Low <br />2PQOO WAG. <br />C;U <br />Signature Data <br />I <br />I <br />