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09. 14 2009 ]()::it FAX 360653943a CARPIN ENT INC <br />a o01/001 <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 ACCEPTED Fi:QM 8 AM TO 4 PM <br />li fez <br />PROJECTADDRES G <br />�/a� asa 8a <br />" � /.� �l zip 98ao/ <br />y_ � ./.(ilGi.i G7Qi �Qi i Ni /h /ten <br />Owner :Nail Address � City Statelip Phone <br />�` <br />_ ( 2". to <br />Tenwit Mai Address City StateZp Phone <br />f 1 /�3T� 9lraTa <3� -�3 9s' <br />Electrical Contract r Mail Address ih Slate/Zp Phono <br />State License Number Contract Price of Work <br />Proposed Use of Building �Q Contact Person (Plan Review) <br />Description of Work to Be Done: <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 hereby cert(fy that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordinances govoming this type of work will be. completed <br />whathor spociBod herein or not The granting of a pe.^nd does not presume to give authonty to <br />violate or cancel the pmvislons of any other state or local law regwatmg construction or the <br />performance of cons ruction. That I am authorized by the ownor of this roperty to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />206.200 WAC. <br />�l <br />On a ate <br />