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Dec-05-11 10:57A P.01 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, 1EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org EI I f Z' o3y <br />APPLICATIONS ARE ACCEPTED FROM a AM TO 4 PM <br />o� �2 ( n6-cL.nC-li L-L E <br />PROJECT ADDRESS S <br />�r�FiRs P1L��L C '•��`.- �9?b Iloc&-- _. <br />Owncr <br />Mall Addross City Stat')/Zip Phone <br />Tenant Mail Addrsss City <br />Alt lftl c-r it lr,4V1cjf _ J�.e <br />Electrical Contractor Mull Address City <br />,E)/64a sf y 2 4 <br />State License NUmhcr I <br />C' v c J <br />Proposed Use of Building <br />De5rription of Work to Bc Done. * 1� r � � N LI,L.- 'Jal <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE, <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />Stalo/Zip yls Phone <br />4'2c)t l Zi4. <br />Stale/Zip Phony <br />T <br />C rn of Work <br />Contact Person (Plan Roview) <br />y certify filar I ttavo read and examined this applicnfion and know the same to be true and <br />All provisions of laws antl ordinances guvennng this lype r,f work will be completed <br />�r specified horcin or nul. Tho granting of a pormd does rrol presumo to give authority to <br />or cancel the ��rovislons of any other state or local law regulating construction or the <br />rance of cppnsfruction. That I am authorized by Ilre owner of this pproperty to perform the <br />v whicli alnliaafion is made and I comply with the Sfafe Cornac(ors Law 18.27 RCW and <br />2 A �s /j/--- <br />FEE <br />v G . <br />