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1�/05/2011 14:14 4254897996 HOME RUN ELECTRIC PAGE 02/02 <br /> Ei.ECTRICA� PERMIT APPLICATIDN <br /> C17Y OF' EVEF2ETT PERMIT SERVICES `n ��� <br /> 3200 CEDAR STREET, EVERE-rT', WA 98201 �� <br /> 425-257-8��10 - FAX425-257-8857—www.everEttwa,org ����o _6a3 <br /> APPLICATIONS ARE f'•CCEPTED FROM 8 AM TO 4 PM <br /> � >q c7"�P`1� �v�� `L�.,� 'C�'2��`��i�J•J � <br /> PF20JE..7 AGDRESS <br /> an r� �' O�SCTC"� �.�i.P�i c�'lp�~�y�xc�'�� ��'`('t��r��P!� <br /> Owner Maii Address Clty Slate/Zip Phone <br /> � \ <br /> �\ � � <br /> Tenanl Maii qadre:s �ity State/ZiP Phone <br /> � �S-�l�i--�'ta� <br /> -���—_�,�.-�.�. �1��`��v l..l�C. P•G `f� �\-1 `���`t�sid= W� <br /> Electrical Contactor Man nnnrccs City Sta��yC� `Phone <br /> —�� <br /> �Q�L��,� k--Z-��"l`'��i�.,�. _ --��'���' <br /> Slale License l�lumbar Contract Price of Work <br /> S. r ,. �. . ���`� ; f r.. s�..�S`a�"�'� <br /> pfr�posed Use�of Building � Contnct PetSoO (Plar Review) <br /> Description of��Nork to Ba Done�. �r\�.��.�� ���� �'�� `� �� `t• �� <br /> l <br /> � (�l `h•^f^i ' ' <br /> NOTE: WIRING IN NUN-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CA6LE, <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hero6y cortiry that I have r�ed and axamined fhis ap(�Ilcafion and know the same to be true and <br /> corrocf. All provisrons ot�laws and onlinances�overnmr�Niis type of wodc will be completed <br /> whefher sped(ed h^re�n or nof. Tfre grantrng of a perm�t does not pi'esume fa give authonty fo <br /> violate or cancel tAe provrslons of any other state or;ocel law rapulating construcfion or fl�e . <br /> perfonnsnce nI construc�ion. That I anr aufhoiized by tho owner ol Nrs`�roperty to periorm the <br /> 296 200 N�AC.aP���ce!ion is made and I comply�sith!he Sta�e Cenfracfors LaK� 18.27 RCW and <br /> �l.` � _ D �� <br /> � � `�, ,-• c� � , � �� � <br /> igwl re Daie <br /> � <br />