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11/30/]011 wED 11: 10 PaS 206G6�6_16 Grcentiood Neating . ��C 0002/002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 I <br /> 425-257-6810 - FAX 42&257-8857—www.everettwa.org <br /> APPLICATiONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> )O��L� I� D,' SE <br /> PRO:IECT ADDRESS <br /> )2.0 — <br /> ��I i o MCl'1 ��s 1���311� I g Dr SG Cvcrc-I-I� Ulft a b'�'� �ti i <br /> Ownei� MaB Address City StatoZP Pho� <br /> t I � <br /> Tenant MoilAddress Gty Slalc2ip �`�ne <br /> �s `Ic�a ����� �e��m�� �25 5 �c�U S•� sec��l� c� ���3� -r�3 25 <br /> EleciricalConUador MaflAddress Ciy Statol7Jp Phono <br /> �S`fi�1,�Y��R2SNm 5� `'' <br /> State License I.umber Contract Price of Work <br /> Si .d� F�mit� he�sirl _ 4ti . S�I�.�NIDnCXIe� <br /> Propo Use af Duiidin Contact Person (Plan f2eview) <br /> Description of Workto Be Done: 1 �1����1 `ILn �u�1 U1.) r (L�(L�1�l.1 W1� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO F[E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY 7F EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereb; certi7y fhaf 1 have read ond examined fhis applicetion and know;he same(o be Gue ond <br /> cormrt. All provisions of laws ond ordinunce.s goveminq fMs type o(work will be complefed <br /> tt�iiclhri specineu herein or nul. Tite yruniing o!a purmd doea nui msumn lo give xulnoriiy to <br /> violafe orcancel fho provisians ot any ofhersfate orlocallew mgu�tmg wnstmction orthe <br /> pedormance ot consfruc;ion. That!am outhonzed by the o�vner o!thispr operty fo peiform fhe <br /> work lor which opplicefion is mode and 1 compty wrfh the Sfafe ContraGors Law 1827 RGW and <br /> 296200 WAC. /� <br /> , �lti �-L.� 11131��11 ��� /� —��r__ <br /> �Sipeaturc Uate <br />