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i t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425•257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 5q�1 �3'=d ,�r. �i✓. S�e, I03 <br /> PROJECTADDRESS <br /> ONTef MailAddress City SWte2ip Phone <br /> �'�dr T�i, S9ol .23�,� W. �ver���/�l f�113 <br /> Tenant Mail Address City state2ip phone <br /> Meril Eiectric, Inc. 19029 36!h Ave West Suite D Lynnwood WA 98036 (425)775-1356 <br /> EIeCIfIC3lCotl�faCtof MailAddress City SWtelZip Phane <br /> O�. <br /> MERITE1044B� �y �S �3� <br /> 7/ <br /> State License Number Contract Pri of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> � <br /> Description oF Work to Be Done: �ci/� ,/��1��o�Grerhe� � <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERE7T LOCAL SALES TAX COOE IS 3105 <br /> l hereby certily that I have read and examined this application and know the same to be hue and <br /> conecf. All provisions o/laws and ortlinances goveming this type o/work will be completed <br /> whetherspecified herain or not. The granfing ola permAdoes nof presume to give authordy fo <br /> violate orcancel the provisions o(any otherstate or local law regulefing construction orthe <br /> per/ormance o/construction. Thaf I am authorized by the owner o/fhis prt�perty to perform fhe <br /> work/or which application is made and 1 comply with the State ContractorsPLaw 1B.27 RCW and <br /> 296.200 WA�C. � ��Q <br /> ✓- /p°Cv <br /> � ignature Date <br />