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10/24!2008 11:17 36�6598578 NURTHERN LIGHT ELECT PAGE O1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 96,�01 <br />425-257-8810 - FAX 425-257-88,i7 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTEp FROM 8 AM TO 4 PM <br />� � Q y (/i' Pi�/n� l °L <br />PROJECT ApORESS <br />Ownar <br />Tenant <br />Contrapor <br />State Licanso Number <br />. <br />h_l`Y.r-p r`�.i z <br />Mad AGdia�as <br />MaB qddress <br />li.�r' iC`�� <br />Mall Addresa <br />Proposed Use of Butlding <br />DosuipUon ot Work lo ee Dono: _ Lti.// �-1� f/ O� <br />�n-.� � c. �c <br />NOTE: WIRING IN NON-DWELLINCS 13 RCQUIRGD 70 <br />R[ IN C.AGC-Wql'S, MC OR AC CAt3LE. <br />CIIY OF CVER[TT LOCAL SA�E$ TN( COUE IS 3105 <br />�Y <br />cny <br />Clty <br />s�at�zip <br />Stni✓7Jp <br />ShrW21p <br />Ccntract PYce of Work <br />Gontact Parson (Plan keview) <br />Phont <br />f�hone <br />Fhone <br />�� �7' 1'✓C c✓ �C% rn� <br />FEE - <br />f heraby cart!ly fhat I hovo ruad and examhved fhis aPP��caUon and know the snme to bo We and C C/ (�� U-�;25 <br />com�cf. �II provisluns oI IaHs and ordinances yuvoming thls rype v! wnrk N�1N be comploted <br />u�hethar specifiod hemrn or not. Thc g�anling ol u pr.�md Aoos nofp rosurtte fo r� d authority to <br />vrolato ur cnnca rhe pmvislons o/ any othm stut0 er Wcal law �gulatinp cvns� �'c ion or lhe <br />peNomiance o! con.Nruction. Thnt ( sm aufhndzed Gy the oHner oI this prvpen,� � a pudorm the <br />�vOrk (or which applkation is made end ! comply itii(l� fho Slafe Con(radors Low , 8.27 RC�N end <br />29G200 H�AC. <br />a�a��b� <br />