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� <br /> ELECTRICAL PERMIT N►PPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 3 ��'�`-� <br /> 425-257-8810 - �AX 425-257-8857-www.everetlwa.org �Qo 3 1�"� <br /> / �i / <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> �Z6D Z3 fnf�!'i'd� w�s7` SUitelb ( <br /> PROJECTADDRESS <br /> OWnef MailAddress City Slale/Zip Phone <br /> �0. q.�� 62�o z,� `°o� wes� CUe�<<i� /,v� <br /> Tenant� MailAddress City Slate/Zip Phone <br /> Merit Electric, Inc 19029 36th Ave West Suite D Lynnwood WA 98036 (425)775-1356 <br /> EleCtflCal ConffaCtof Mail Address Cily Slate/Lp phone <br /> MERITE10448Q LrQ 0 <br /> Stale License Number Contract Price of Work <br /> Propnsed Use of Build!ng Contact Person (Plan Review) <br /> Descnption of Work to B�Done: .J�.0 5 f�•/C y DOad l� ,D pPL<,Y REG r�fue L�r <br /> NOTE: WIRINI: IN NON-DWELLINCiS IS REQUlRED TO FEE <br /> BE IN Rr`:CEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE�S 3105 I, <br /> I hereby certily thut 1 have read and examine�this application and know the same to be true and E�{/3 ' I I� <br /> correct. All provisions o/laws and ordinances geveming this type o/work wi116e completed <br /> whether speci6ed herein or noL The granting o/a permd does notp resome to give authontc to <br /> violate urcancel the p�ovisions of any other state or local law regu/ating construcfion or the <br /> perlormance of construction. i haf I am authorized by the owner o/fhis property fo pe�(onn the <br /> work lor which applicafion is made and 1 comply with the State Contrac(ors Law 1827 RCW and <br /> 296.200 WAC. <br /> i <br /> �. ;� ��/:� , � - Z �/ o�y <br /> Signature Dale <br /> � <br />