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NOV/08/2011/TUE 10:55 AM FP1 Seattle FAX No.4252909600 P.001/001 <br />c c <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org (f-//// _067-- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM p <br />PROJECT ADDRESS <br />T-, 'E4 L &,, 0�0�� Wcirayn Lve✓rtrf� ��i-0l -� 99 <br />Owner Stall Address City State/Zp Phone <br />Tenant Mail Address City Slate/Zip Phone <br />r,�,t PiroAA Iz, M R121I N -Ad 660k, 14,a Y909L 9 i�17 0_fiOo <br />Electrical Contractor Mail Address City Stateop Phone <br />rTk i5?f-,to' -r �,� —1 Old <br />State License Number Contract Price' /of Work <br />ra/ <br />Proposed Use of Building Contact Person (Pla#lReview) <br />I0'," (io�fa�1 <br />Description of Work to Be Done: i �^'t�-'1 r. R <br />�ar S s <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this application and know the same to be We and <br />correct. All provisions of laws and ordinances governing this type of work will be completed <br />whether specified herein ornot. The granting of a permit does not resume to give authontyto <br />violate or cancel the provisions of any other state or local few regulating construction or the <br />performance of construction. That I am authonzod by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Law 18.27 RCW and ^� <br />296.20Wre <br />/) I I _ 0 /� Q, <br />/ l I ll' <br />Date <br />r% <br />