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11/20/2009 10:18 3606590570 NORTHERN LIGHT ELECT PAGE 02 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425.257-81357—www.evorottwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> !/f'/ z ;79 N 'Sic- <br /> PROJECT AUL)Ftrss <br /> �^� fal�1`La I✓I �C. Gl77� �r�..-h !� _,_. -__ _� _ ._. _.._. __r-- <br /> Owner Mg Addtis �:�ly SL71C(ZIp Phone <br /> Tenant Mae Addmss Uy _--- SmMZp Pawn <br /> Electrical CoNlactor LiMll Address oy Stuio2ip Phony <br /> State License Number Contmcl Price of Work <br /> Ptoposca Use of Building Contact Person (Plan Review) <br /> Oescnphon of Work to Be Done. - -w/ - Y0 <br /> NOTE WIRING IN NON•OWELLINO9 IS REQUIRED TO I Et <br /> ` BE IN RACLWAYS, MC OR AC CAOLE <br /> i <br /> CITY OF EVERETT LOCAL SALFS TAX CODE IS 3105 <br /> I !herety cedrfy that I lin <br /> and cram ed W7 nppllCAflnn and know the sarrhr(o bd hue yard j� /y I— 'i 1 1 <br /> I tenet( All prevltifens of taws and an "6, <br /> povcrnlnyy this typo OI H[Yk will hn�rxrrplMed l�ll1 '1/ <br /> whether 3"proed humin not. 77ro grenNnp of a lwmrk does n� msumn. In plot aufhorrfy 10 <br /> vfolal9 or cancel the prvv(gsrions of ony other state orfocnllawmpu�fhrp carainicffon afho <br /> poAemrence of c nstrvcffon 7hnf I am aufheAxodby ffra owrrnr Nfhi.e1frct/a�rty txNMrin the <br /> wort,/or which applicafkm Is mddo end f comply wAh the Stale Contra rs Lew 18.77 ttCw ono <br /> 196 200 to C. <br /> a z a q <br /> ianature --'rate �7 <br /> I <br /> i _— <br />