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MRR-14-2010 18:33 From: To:2578857 Fage:l'1 <br /> � <br /> , ELECTRICAL PERMIT APPLICATION <br /> .`h EITY OF EVERETT PERMIT SERVICES <br /> `;E�� 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425•257-8957—www.everettwa.org <br /> ' APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM <br /> � 51 S �aG.�U �ve. � /0 Z <br /> PROJECT AD�RESS <br /> Owner f,�ail Address Ciry Stald2ip ��� Phone <br /> � � )��IU C1J� <br /> Te n� �dail Addross Gty SlalclZlp Pnone <br /> ���-o► �G�� aa� i C' ��� �i1Q�P�� �1B?ol �� - 655 <br /> [Icdripal Conirndor Mai�AdUross Clry Stale2ip Phone <br /> So�zrP ��'��D7 � I , � 3a. � <br /> State License Numhr.r Contr�ct Price o(Work <br /> —��t(,� �S�j'(,�.Q,� �P 11 ��'�� <br /> Proposed Use of Bu�ing �- Contact Persor (Plan Reviow) <br /> De.trip�ion ol Wnrk to Ae DO�B: 1,�t� V� I , �U�, <�Llil.l./ � ��/./T(�/✓� <br /> c�n�"a / �7 d��f�c.�s� <br /> NO7E: WIRING IN NON-DWE�LINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE-TT LOCAL SA�EB TAX CODE�5 3105 <br /> 1 hereby cenily fhat I have read end examined this epplrceBon end know the same to be true and L I ��"U r�9 <br /> ouneci. nll provisions o!laws and ordlnances govcmrnp this rype ol work ndu be completed <br /> H�he(Irer specified herein or not The granfing o/a ponnd does not presume 7o give autbonty fo <br /> v�olate or cencel iho provisions o/any ctRer sfate or local law regulo0np consfn�Ction or:he <br /> pi!rlonnnnCe o(ConSirucfion. Thaf 1 em sothpnzed 6y fhe ownerol lhis prepeRy t0 p9rlorm the <br /> work ler which applicetivn Is mado and I compty with the State Contractors Law 18-27 RCW and <br /> 2�J6.2 IM1�AC. <br /> �� 31�s/�o <br /> �� ,�'�ec� �Z�S 9"7 ) -a5�� �' ��' �'�mUL+f , <br /> � -7-�.J.X <br /> ���� � <br />