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05-07-2009 03:00 RLP 3606588944 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETI' PE�MIT SERVICES <br />320G CEDAR STREET, EVERETT, WA.98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATONS ARE ACC.EPTED FROM 8 AM TO 4 PM <br />2�1-0 i 5��' �'r- SW .�verei-t-, W/� 9P?�3 <br />PROJECT ADDRESS � <br />pwner <br />Mall Address <br />MaN Address <br />City <br />Clty <br />Stafi2ip <br />Smreiup <br />PAGE2 <br />5-�-�g <br />�ogD s-d�13 <br />Phone <br />Phpne <br />n�nrrur� �rn�_ ns a��(��(.� <br />EleciricelContractor Mauaanress G�ry S��W �OfR <br />NIA _ <br />Slat LifRnse Number <br />�,� �I ("iP Yl( P_ <br />Proposed Use ot Buildi��g <br />�1/A <br />Con ad Price ofwo�k <br />Contad Person (P16n ReVi ) <br />r . � �. : V � � t .• �� � � � ". = .IJ[I. � <br />NOTE: WIRING IN NON-DWELLINGS IS REQUIRF.DTO <br />BE IN CtACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAI SALES TA%CODE IS �105 <br />I here6y coitr(y fhat 1 ha�e read and examinad this spplicnfion aml knoW tho same fo be tn+e end <br />cor. yct. All pmvisrons o//aws and ottlinances govemrny fhis fype al work wlll be completed <br />whofher specified heiein or noe Tbe granting ola permit does ral p�esume !r g)�e aufhonry to <br />violafoo�canColthp provisionso7anyotharsteteorfocellBwregulatinyConshudionorfhe <br />peAormence o(c�onsinrcfion. Thnl ! am aufhonzed by Ihe ownerol fhis property to peAomi the <br />work Ior which applicafion is ttiado and I c�mply wifh fhe Sfate Contracrors Law 18.27 RCW and <br />286.�00 WAG _ , ,q <br />FEE <br />C L^�US c�(3 <br />