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Feb 09 09 03.07p Puget Sound Contracting <br />02/09/2009 15:58 FAX 425 257(P057 <br />EVEHLII VtK%ll JLnVADCJ <br />253-627-5804 <br />p.t <br />ELECTRICAL PERMIT APPLICATION ' <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVE RE 1—f, WA 9820 <br />425-257-8810 - FAX 425-257-8857 — www.averettwa.or9 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 13M 45;- -03 <br />/V v T <br />25 UV ?�1Yr 7 r <J (��c�c,J i�%Z �r (, f-U f C <br />PROJECT ADDRESS <br />cCl VickI oPCc s C' <br />I�JeX S � S�nrc �a�ave �53- �7--,? F-3 <br />Owner Mall AOdross City Stalamp Phone <br />Ut�-7rrr )53 Lo�7 5zo� <br />Tenant <br />Mad AOOfe55 cuty $[Bad P PhW0 <br />/' / /& �c�arl S� <br />.. So[l</CX CTi/� E / �. CC/�- -77, �/at Gt/ �' `% U - � •- ��� <br />Gty SlatelLip 2Phone <br />Elect 1 Con7aclor Mail Adores u��✓� <br />�i� G ETSC �l � � C �, .�Soy— ✓ <br />Stale License Number Contract Price of W rk <br />GUTC <br />Propocod Use of Building Contact Person (Plan Review) <br />Deecriplfon of Work to BD Dono: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />DE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certtfy that I have read and examinod this DpplicDbon and know the same to be Wo and ���� _ <br />correct. Allwohalars or laws and urdinanctis goveming fnls type of work wi'I be completed <br />whadrer speci ,ed heruln ornof. rhn Omnting of a inernnt doss nul presvnre to gh•C uutironry to <br />wO1dfC rrcancel the prnvlsfons of any other state or local law regu ahng consf'xbOn or trio <br />performanco ofconslrucfion. That I am aurhuriz by trio owner of this propCrh• to poAamt fF,O <br />work for which aAplicabon Is gwde and I compry with the Stale Contractors Law t8.P7 fiCNland <br />296.200 I•VAC. <br />'C 1 <br />e� <br />