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�1/12/2006 08:10 3606598578 NORTHERN LIGHT ELECT PAGE C1 <br />�r <br />ELECTRICAL PERMIT APPLICATION <br />GITY 0� EVERETT PERMIT SE'RVIGES <br />3200 CEDAR STREET, EVERETT, WA 982C1 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM - DEBIT & CREDIT CAROS ARE NOT ACCEPTE� <br />7.� O � � D�2 ti✓ .t..b � /.3 <br />PROJECT ADDRESS <br />� . > <br />G, � r. ,� n <br />Owner <br />Tenant <br />r <br />�.r�f` cr <br />Elecvlcal Conlractor <br />State Llcanse Number <br />Pmpased Use of Buildln9 <br />r r^!6'�.. <br />Nali Adaress <br />Mall Atltlross <br />,�� <br />M2il Addnsn <br />Clty <br />Clty <br />c, � /! G <br />Clty <br />State/9p <br />S�ata/Zp <br />Stala�7Jp <br />Con[rac2 Pnce o� Work <br />Contact Person (Plan Review) <br />Fhone <br />Pt1o11C <br />Phone <br />� _ <br />Deacription of Work lo Be Done: w/ �" `� yK w 1j/o y,�+ '�, _ <br />NUTE: WIRING IN NON-DWELLINGS IS REQi11RE0 TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />C1TY OF EVERETT LOCAL SAL�S TAX COOE IS 3105 <br />1 he�eGy certify thef 1 have read and examined thls appUcetlon end know the same to Oe We entl <br />comect. AU provisiona ol7aws and ordinences goveming this type ol work will 6a completetl <br />whether specifiad horoin or noL The grondng ot e permif does not presume to g�ve aufhonty to <br />violate or cancel the provislons o/any otherstate orloca/!aw regulating consWctlon or the <br />peAormence of constructian. 7het 1 am authonzed by the owner o/ this property to per�orm the <br />work for which epp/iceBon is made ond ! compfy with fhe Stete Confrac(ors Law f8.27 RCN and <br />296.200 W.AC. <br />£E <br />C iJ c!'ol -%U � <br />