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JUL-13-04 TUE 12;50 P11 EVERETT PERMIT SERVICES FAX N0. 425 257 BA57 P. O1 <br /> 415 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREE7, F,VERETT, WA 98201 � <br /> 425-257-8810 - FAX425-257-°857-www.everettwa,org �2_�c�,� <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM - DE81T & CREDIT CARDS ARE NOT ACCEPTED <br /> 121 G Piarine View Dr, Gverett, WA �8'LO1 <br /> PROJECT AI7DRES5 <br /> PSG 121 r �larinc Dr. GvereCC [vA 98201 <br /> Owner +V �dailAddress Clty StateZp f'hcue <br /> na <br /> Tenan[ Mall qddre:s Ciry Slate/Zp Phono <br /> Seven SisCers, Ir,c. G13 Sunse6 Park Drivc Sedro [doolley WA 98284 3G0 856-0842 <br /> 6:leclrical Contrar.tar Mail Addmss City State/Lip Phone <br /> SLUGNSI199JT $4,250.00 <br /> St..te License Number Contrect Price of Work <br /> Propos�tl Usc nf Building Contact Person (Plan Review) <br /> Description of Wurk to Ee Oone: instrument and li�ht at meter station <br /> NO�fE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> 6E IN RACEWAYS, h1C OR AC CA6LE. 144.50 <br /> CITY OF CVGREI?LOCAL SALES TAX CODE IS 9105 <br /> 1+�araby certify ihat 1liava road and examinod tf+is app�lcs�ion and know the same to be irue 3nd <br /> corract All provisions o(luws and ordlnances govomin��hls rypa of work will be comp/efe� <br /> whather spzcilie0 herein a noL The�ranting o/a permR dnes notnresume lo gi�re authonty to <br /> viol�le oi c�ncel tho pinv)s7ons o(any other stefe orlocal law regulatinq constNc6en or the <br /> paitunnancc o(ccnslrucYon. 7hat I am authorized by fhe owner of this propedyto peAcrm the <br /> v,ork lur which applicalion is mado,�nd 1 ccmp/y�vlfh tha St2te Contractas Law f8.27 RCW and <br /> ?90.200 Wi1C. <br /> �,��� :)(�.��.,i- .��1 z�� l��l <br /> � ,Sigi ture Date � <br /> : <br /> E a��,a-�S c� <br />