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OCT-04-2005 14:20 360 757 0347 P.02i02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX425-257-8857—www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM • DEBIT 3 CREDIT CARDS ARE NOT ACCEPTED <br />113) - I Lit, sr s.E <br />PROJECT ADDRESS <br />1.S <br />Sh1tleLC-Y 4+$k1Vt-4&&0J 1-131-7Nt sT sa, P-de4CO LJA- 11y3 3 K'r-I <br />Owner Mall Address CRY Stalol Phone <br />Tenant Mai Address City State2ip Phone <br />owi►wEt3T- W, ztii44 * wwAJro sa /5 -1411 mv- STYE, AdoiA N�T. Lot fta3 <br />—� <br />Electrical Contractor Mail AddressAddressCity Stele2ip eS3/-y31Ia .3 <br />State License Number Contract Price of Work <br />L Tin+ - yzr— 3-1-8 - 7os <br />Proposed use of Building Contact Person (Flan Review) <br />Description of Work to Be Done. /jl1 of 1N� Q o TiDoi lLY] <br />ys 3 6 _ <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 0108 <br />1,10l w leaf 1 have road end e.emrned this appikanon and krow the SSame lobe hue end <br />coned. All wsiona of laws and <br />ordinances p veming this Npe of work will be completed <br />whemer ed hereln or nof. The pranhn o% permit does hofD resume (p glue auNortry to <br />violate or cancel the provisions of any ofner gtata or local low lel slog cons Wchon or the <br />parformance orcon hucoon That 1 am aumvzod by the owner of thn Pproperty top the <br />wonr /fpp�� w,e appi canon is made and l comply with the State C infractors Law T 8.2T RCW and <br />298.200 WAC <br />Ja. & A&A'stelf— <br />Signature Date <br />TOTAL P.02 <br />Fd510 hzH <br />