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08/15/2011 10:38 FAx �001 <br /> 1 �+ <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVEREIT PERMIT SERVICES g` ���,�� <br /> 3200 CEDAR STREET, EVERETT,WA 98201 � <br /> 425-257-8810 - FAX425-257-8857—www.evereriwa.org �I' O� 3 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 13oq E, r1�tar;ne ���e� ����/�- <br /> PROJECT ADDRE9S <br /> (�cile, Deleri ►'1 [� 3� �3ro1 AUe SE S�� �Iz�mi��h c.�A 98aqb <br /> Ow�er Mall AAdreac Clry StatelLp Phune <br /> V Cl CCI.VI.�� <br /> Tenant Mail Addrese Ciry StatdLp Phone <br /> ���r��frr�ance L-lec�r�e �30-� a ganca �i � � �ar,�d g �aaa <br /> EledricalContrador MallAddress cny Statemp ,s�_5�,�ey5 <br /> ��12 Fc�el q lq o8 50�.oU <br /> State Liconse Number Contred Price of Woi1c <br /> �� �u�� Contact Person (Plan Review) <br /> Proposed Use of Building <br /> Description of Work lo Be Done: <br /> N.��.J !�5 �1rrtP �-v�v�c�e <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> 1 hersby co�tify Ihat 1 have road and examined this applicetion and know tho same to be hue and <br /> correct. All pravisions o/lews and ortiinances gaveming fhis fype of wo/1c will be.complefed <br /> whether specified herein ornof. The granting o1 e permrt does not presume to grve authonfy to <br /> violofe orcancel the provisions o�any ofher sfefe or locallew regulafing cansfruction or the <br /> peAormance o/consf�vction. That I am aufhorized by the ownerol fhis property to peAorm fhe <br /> worlr for which applicehon!s mnde end I comply with the Stafe Contractors Law]8.27 RCW and <br /> 296.200 WAC. r <br /> ���v(;� �--�.v�� �. �5-! � ��o�. � �3 <br /> Signalura a�e <br />