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ADr.27. 2010 9:53PNI %_.1589 P. 1 <br />it <br />ELECTRICAL PERMIT APPLICATIh <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETI, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wrvwv.evorettwa.org <br />APPLICATIONS ARF ACCEPTED FROM 8 AM TO 4 PM 100q -ICd <br />j L 1 / r <br />PROJECT At1DRESS <br />Owner Mail Address City StatoZp Phone <br />Tenant Mail Address City State/Zip Phone <br />&i S Fl�.l a r Cnnt,ht LZ¢c�rw7;t e, '5 ® Mg-v% rn,,,kroe Us A- 9c.:i)7a. S rocJ 74Y 7. <br />Electrical Contractor Mail Address City State/Zip Phone <br />CsSNrb.51-I93e)P_k fd 1 01S0-" <br />State License Number Contract Price of Work <br />i,naI,_ f.., ly I�sg•oly t.+ � � r- �z,4rcuas)�rti <br />Proposed Use of Building II Contact Person (Plan Review) �3q <br />Description of Work to Be Done: �"c(da�N C• %+�u w� ! .L a Ge <br />fig t R, 4 d d <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA)( CODE IS 3105 <br />I hereby certiry that 1 have read and examined thrs application and know <br />the same <br />to be tme and <br />correct. All provisions ollaws and op"' ances govem,ng this type orw0rk will be completed <br />whetherspecl0ed herein Drool. The granting of a permd does not Aresume fo give authority fo <br />violate or cancel the provisions o�reny other state ortocal taw regulating construction or the <br />o orwnrch sppl ca /f o/7 on is medal and 1 cotmplzed <br />µ7fhythe 8fateaConhhacP�plew 10 27 RCW and <br />236.200 WAC. li /v <br />W.4t ka" ti%7 ( t e 7 <br />Signature Date <br />3-3c <br />