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� <br /> � �Ihr' � �U�//-0.2� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES S_ �,�g <br /> 3200 CEDAR STREET, EVERETT, WA 98201 / <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.org [/DD s�8v <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> � $�� ,23� �1�. I/I� S�e. �63 <br /> PROJECT ADDRESS <br /> ONrt1er ailAddress City State/Zip Phone <br /> `/�/As �hu ��� v�amr�lP� <br /> Tenan� MailAddress City StaleRip Phone <br /> Merit Electric, Inc. 19029 361h Ave West Suite D Lynnwood WA 98036 (425)775-1356 <br /> Electrical ContraCtor Mail Address City SWlelZip Phone <br /> MERITE1044BQ /�' /� �� ' <br /> —.l)'_T <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Oone: �� � �{��rd(/�7 ei1 � <br /> � <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 fhat 1 have read and examined this applicafion and know the same to be fiue and �\W h ""U�10 <br /> correct All provisions of laws and ordinances goveming this type o/work will be completed <br /> whether specified herain or not. The granfing o/a peimd does not presume to give authority to <br /> violate or cancel the provisions o/any other state or local law regulsfing construction or the <br /> performance o(construcfion. That 1 a.m authorized by fhe ownero/fhis property to perlorm the <br /> work/or which applicafion is made and 1 comply with the State Conbac(ors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �-,20 20/0 <br /> Signature Date <br />