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JUIJ-14-2006 09:36 FP.OM:PERPIIT 4257756315 T0: 14252578657 P.3 <br /> l 1 <br /> ELECTRICAL PERMI'T APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVEFETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED fROM 8 AM TO 4 PM - DEEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> �ti3 o Pa h0.1/i� �/� <br /> PROJECT ADDRESS �zJ��yZ �� <br /> Gf1a.�-1�- S'dGv 2S3d �ana vs2r�, /,��VJr ���C�� �Pzo3 <br /> Ownef Maii Address City Slate2lp Phono <br /> �l'a r�.C� <br /> Tenant Mail Address Ciry Stale2lp Phone <br /> �/�lr� �!�a-���'e.�//�' 2� G�l� �ie4J �CI.�� ' �6�� <br /> Electrical Contrecl M d Atldress Ciy Stale/Zip Phone <br /> c,v�J'K/EJ'�'t ?ldO 7S1�� — <br /> State License Number Contract Pdce of Work <br /> �J'�/� _�Cl l��/N�t i ��2�'r�'' <br /> Proposed Use of Building Contact Person (Plan Review) <br /> /' // ' / /` � l5= 2d ,� � <br /> DoscrlpUon a(Work to Be�one: J !( l vf �C�T�l �/ <br /> — y--�,,� �5=���p — <br /> NOTE: WIRING IN NON-DW[LLINGS IS RE�UIRED TO FEE <br /> BE IN R,4CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALE9 TAX CO�E IS 3103 <br /> I horeby cerfity fhat I have read and axaminad th/s appllcalion antl knmv the.�ame fo 6e true and <br /> correcL All provisions ol laws and ordinances goveming fhis type o(work wid be compfefed <br /> wherher specillod herein or noL The gran�ing ol a permu does not presume to giva authodry to <br /> viofafe or cancel the provisions ol any other state or local law regulating con:truct�on or fhe <br /> pedormance o(construction. Thaf/am aufhonzBtl by the owner o/thls prope�rty fo peAoim fhe <br /> work lor which application rs made and I comp/y wdh fhe State Contractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> � �1�� ; / I , <br /> iS�aWre C Da�e � l�"`�'7 <br /> _ ,�� I <br /> L � <br /> , <br />