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09/22/2006 10:42 PAS :1606s:i 9435 GARVIN ENT I\C <br />Z 0ot/001 <br />I <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 — www.everettwa org <br />APPLICATIONS ARE Aci-EPTED FROM 8 AM TO 4 Pfd <br />-- / 20 /LJ <br />PROJECT ADDRESS <br />k a <br />n Mall ddress City Stato/Zip Phone <br />Torant Mail Address City Stato/Zip Phone <br />J. 50V /�F3C <br />---7 <br />Electrical Contractor tAail ddT ess r ty Stato2ip Phone <br />State License Number Contrad Price of Work <br />.'ropose Uso of�uildino Contact Person (Plan Review) <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />Do <br />BE IN RACEWAYS, MC OR AC CABLE.�� <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 horoby certify that I have read and examined this oppl/cation and know the same to be true and <br />correct. All provisions of laws and ordinances Ors <br />govomrngg t}7 a o; work ni/1 be completed <br />whether speclOod heroin or not. 7Ae granting of a porm t dons not resume to give authority to <br />vlolate or cancel the provisions of any other state or local law regulating construction or the <br />porfommanco <br />of construction. That 1 am authorized by the owner of this roperty to perform file <br />work for which opplication Is made and I comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. �l <br />Signatur Date <br />I Q <br />V <br />