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FEE-11-2010 04:OSP FRON:DAHL ELECTRIC-EVEEET 425-252-2999 TO:425257S957 F.2'2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — wanv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />✓t�2e' 22� %7.20 1L2� ���¢ �' o3 fy6-3�01 <br />Owner Mail Address City Slatoo'Zip Phone <br />Tenant Mail Address ON Slate/Zip Phone <br />yzs - <br />M e- AI�l�.ZZ/����i�E�r' 1S2o1 .2s2 r�oa <br />Electrical Contractor Mall Address City State/Zip Phone <br />00 <br />Doff-[-.�qD �o, ono . <br />Ulate License Number Contract Price of Work <br />PropfisLyd Use Of 801di g Contact Person (Plan Reviuw) <br />'.•,Da ript� ork to Be pone: ./�bf�1GC(!� O-l-t i /i/6�,, �•j�Qi ifi(/ ._ <br />ill//////VVV///,,/,,j///!!!//////l� oZ- .�Cl�/(,� � —/�O' ✓C�CG} <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, IVIC OR AC CABLE. �O <br />aso . <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certih• Illat I have read and exomhrad this application and know the same to be true and <br />correct. All provisions of laws and ordinances governing this typo of work Will be completed <br />wbothor spuclried heroin or not. The granting of a permit does not p resume to give authonty to <br />violate orcnncol tho provisions of any other stoic or local law reguloting construction or the <br />pert, rmanca o onsiruction. That I Dill alltticrized by the ownerof this pproperly to perform the <br />work for whit pplicetion !s mD and I co ply with Ilia State Contractors Law 18.27 RCW and <br />29ti.20 W <br />(Oct-0(os <br />SIDnlur D2•o <br />