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Jan 14 09 11:41a Keller electric, Inc. 360-668-7431 F.1 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET. EVERETT. VJA. 98201 <br />425-257-8810 - FAX 425-257-aa57 — www.cverethNa.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />L4 <br />PROJECT ADDRESS <br />�ur�r�f�Sc1�� <br />Owner Mal Address City StalelZiD Phone <br />P T — c <br />Tenant Mal Address City Staterzip Ptron, <br />Electrical Contractor Mal Address +-IC ^G 3Gty State/7-0 c=x Phone <br />a <br />State License Number 11�; DC/ Contract PrfcL of Work <br />Proposed Use of Building <br />{(�i - ` C <br />ontact Person (Plan Review) 1 <br />Description of Work to Be Done: PO)'r�M �� �. !'/�% IC'c / rl `cr <br />ec� -'sty <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 CODS IS 3105 <br />1 hute y certify that I have reed and examined his application and know the same to be true and <br />correct. Atl pmvfsons of laws arid, ordinances govcvmng this type of work will be Completed <br />whether s7xnl ied homin or not. Tito granting of permit does not presume to give authority to <br />vlalato or cancel provisions oovisions of any other state or local law regulating construc km or the <br />parlorme ce of cowdruction. That l am ayttmaitai by the owner of this property to poAarn !hc <br />work for idt applicuton is tnade.arryl'/�npty wdlr Ore State Camhacl�rs Law t'8.27 RCLV and �L <br />296.2 C. <br />I <br />ate <br />Al <br />'pft <br />