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02/11/2013 15: 41 F,1d 4253357830 PdRNELL ELECTRIC <br />[0 00,1,nua <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.averettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECTADDRESS <br />tie6Z[ Co. k-;T9N15`j SI'�7 <br />Owner Man Address City <br />vafelZlp Phase <br />Tenant Mail Address City Stale2h Phone <br />1kic- Lids Sr'- 14 Lr�' ^ Electrical Contractor Mail Address Gry StaMlZip Phone <br />S' a,'n he _ � , <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Persen (Plan Review) <br />Square Fwtujc l., ,�iuential new construction, remodel oraddition) <br />Description of Work to Be Done: vJ 1 t"-ti~ QL\..1 CJC�.S� Q,v GT IO lJ <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 />4 Ll cc <br />I hemby corti/y that ]have road and examined this application and know the same to be hue and t- <br />whotha Nf provisions of fawn t T or gr axes p'a pe iag this type of work will be completed <br />wlhother specffad twrperion�osrronot TMt granhng of a permd does not resume to give a to <br />viol%oromanc of oonsinrc6onn.nThat 1 a auuother <br />fl omed bor � fowriar t�po rl p�po� Uro <br />wvM for which application is made and I aunply with the State Conhadors Law 18 27 RCW and <br />296.200 AC. <br />S pne Date - <br />