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May, 2D. 2009 2:260 CJ Electric & S u P P ! y No.0161 P. 2 <br />i <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-0810 - FAX 425-257-8857 — www.evere(t%va.org <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />60 <br />136 <br />PROJECT ADDRESS / <br />Owner Mall Address City Stale/Zip Phone <br />f?_` <br />Tenant Mail Address City State]Zip glo _ 'f; of <br />C1 2y317 Nr. t- PL. "�A-101"Al5df. t,✓rs f b47 V <br />Electrical Contractor Mail Address Clly SlaldZlp Phan <br />Stale License Number Contract Price of Work <br />�J- ,c%;Ll CCOL <br />Proposed Use of Building v Contact Person (Plan Review) <br />Description of Work to Be Done: <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 />I hereby certify that I have read and examinod this epplication end knowlhe same to be true and <br />correct All provisions of laws and ordinances governing this type of work will be completed <br />whether specified heroin or not. The granting of a pormit does not resume to give authority to <br />violate or cancel the provisions of any other slate or local law regufating construction or the <br />pertonnanco otconstruction. That I am authorizod by the owner of this property to perform the <br />work for which application is made and I comply with the State Contractors Caw 16.27 RCW and <br />296.200 WAC. /'t <br />Igirature Date <br />