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No�. 21. 2011 1G:3BAM No. 116fi f' o <br /> i, <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES f� _ .a�`�� <br /> 3200 CEDAR STREET, EVEREFT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.Org C��� / —1� <br /> APPI.ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ,q�S �R���c�.v C�re,�ett' w P� ��Zo 1 <br /> PROJEC7A�DRESS <br /> �olo►�.S `Jfirotx� 50.�� 425 '�3�i I 3`Z I <br /> Ownef � Mail Addrese Cily SlalelZip Pnone <br /> Tenant Mall Addreee Clry SlaleRip Phone <br /> CM n�i na InL 14�15 I�roc�,�-r� C e�G�l��A�?0 I �z5� 2�i (o��� <br /> EledricalConVactof � MeilAddnss cily 51ata21p phone <br /> G�1F�EA�Mk1�Q��_ �223, �I-y- <br /> Stata Ucense Number CorUact Price of Work <br /> Proposod Use of Building Contact Person (Plan Raviow) <br /> Descriplion of Work to Be Done: 1 n �vH r �l <br /> N07E: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE� <br /> CITY OF EVERETT 40CAL SALEB TAX CODE IS 1705 <br /> 1 here6y certify fhaf 1 heve read and eKemined this appficafion and know the same fo be 7ue and �I I _ I�� <br /> correct. All pruvisions o/laws and ordinances goveminq this fypa ol work will De complete0 �1� I <br /> whethe�speciNed herein ornof. Tho pranfin0 0l a perm�l does nof resume lo give authority lo <br /> violate or cancol lhe provjsion5 ot eny otharsfato orlocel law�aguPating cons�ruction or the <br /> peAormance cf constiuchon. Thaf I am aulhonled by the owner of fhis property to perform Iha <br /> work for which epplicafion is rnade and!comply Hnfh fhe S(s!e Conhecro�s Law f 0.27 RCW and <br /> 296.200 WAC. <br /> 1��h , c ��-2i- � � <br /> —� Slgnalure � ate <br />