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03/10/2006 OB:20 3606598578 IJORTHERN LIGHT ELECT PAGE 01 <br /> •j <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 /> APPUCATIONS ARE ACCEPTED FROM 8 AM 7o n PM <br /> i/� � IQG� �hiYr z'Ir � 7rs�N <br /> PROJECT ADORESS <br /> S�'�v�n ��,�✓�+-�i _ <br /> Owner MaIIACdress Cily State/Lp Phone <br /> Tensnt Mail Addross CNy Sb�a�Z�p Phmi <br /> /1�6v�/IC✓1J .�+7f+'/ .LI/Y2 ���^ <br /> Electrlcal Contraclor Mall Address City SutaZp Phona <br /> Slale Liccnse Number Contract Price of Work <br /> Proposed Use of Bufldinp Contad Person (Plan Review) <br /> n�c�rtpUon or work co eo oono: t.t��/t�/ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TA7(CODE IS 3105 <br /> 1 here6y certily fhet 1 heve read and oxamined fhls eppficatla�end know tNe sume to De frua and <br /> r.xracr Atf provlslons ollaws and ordrnanqes po��eming thls q�e ot�irork�rill be cempleisd <br /> �+hether speeified hcrcin or noL Tha grarrfmg o!a pem�d does not prasume fo give authonty tv <br /> rioleta or canc I thn prorision�ol eoy other stete orlocal Isw repuletiny construction o the <br /> performance o/�construcfion. �fhat f am authonzed by fhe oimer o/ihis property to perform the <br /> work for which application is made and 1 compty�+�fh Ihz SYate Contrac(ois Law 1827 RCW and <br /> 296.200 6l'AC. <br /> ����/ '3�/0 �o� � � � �Jj-v i� <br /> Ignaturo oala � ` � <br />