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12/02/2005 08:40 3606598578 NORTHERN LIGHT ELECT PAGE 05 <br />T' , <br />ELECTRICAL PER�VIIT APF'� iCATION <br />Gi7Y OF EVERE7T"1'ER�MIT SERVtCES <br />3200 CEDAR STREET, EVERETT, WA 992U1 <br />425-25?'-8810 - FAX 425-257-8857 — miww.everetri�✓a.org <br />APPLICATIONS ARE ACCEPT'cD FkOM 8 AM TO 4 PM - DEBIT & CREDIT CARD� ARE NOT ACCEPTEa <br />��d o 9 � D,- t.,/ ,Lo�'.t�` <br />PROJECT ADORESS � <br />Dwner <br />ienant <br />Jectricai Convacmr <br />Mail Addrncn <br />Mail Address <br />ilate Licenee Number � <br />'ro��aed Usa of Building <br />)escription of Wark to Be Done: <br />JOTE: WlfiiNG IN NON-DWELLINGS iS REQUIRED TO <br />B� IN RACEWAYS, MC OR AC CABLE. <br />:ITY OF EVERE7T LOCAL SA�ES TAX CODB fS 3105 <br />� <br />Gy <br />Gty <br />SISN_21p <br />suamn <br />Stace/Zlp <br />GOfitf�'C: PtIC2 Of WO�t( <br />ContaG Person (Plan Revlew) <br />ha�eby cert;l}� rhat ! havo read and exemined lnis ap�!lceHon anJ knmv the seme to be true end <br />onaci. All provisions ollawe and ordrrtances ao��cming thrs typo ofwerk wd( be cvmpieted <br />ihethzr specAfed herein or not. The qrenBng cf a permd does notp resume to give authcnty lo <br />lolate or cance/ the provisions vf any oihersfata or/ocsllaw ragulah�ng construcGon orthe <br />ro�k lorelvh ch aFpll craVo s� m�de� and I comply � fhB Stafe Con�c ospEaw 18 27 RCW 1e d <br />96.200 WAC. <br />Phono <br />ano�o <br />FEE — i <br />1 7 <br />�/Z-(j17 <br />