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01/02/2007 12:23 36065SB578 NORTHERN LIGHT ELECT PAGE 01 <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.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> PROJECT ADDRESS <br /> �u7r /lrYA`�� / J <br /> Owner Mall Kddross Gly state/Zip Phone <br /> Tennant ,Mail <br /> Address Gty State/Zip Pr,pre <br /> nt�0 rWt r <br /> Electrical Contractor Mail Addrew —` rry Stite2lp rha,e <br /> State License Number Contract Price of Work <br /> Proposed Use of BuildingContact Person (Plan Review) <br /> Dascrlption of Work to Be Done: _ (�// /"2�/ 4G w /76 rlv )r <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF CVCRCTT LOCAL SALES TAX COUP-IS 3105 <br /> I hereby cert!/y that I havo reed end exernlrred ffrls applicehon and know fhe same ro be truo and <br /> corrocf. Apt provfslons (laws and or0lnen�e�pp pm((np Is type or work will bo compl/etetl <br /> whether a eelfi here n not. Tlro Gran!n o a ermn doe not resume fo glue eufhorffy fo <br /> vialafe orcance/fhe pprovlslons of any other state wlocellaw reguPfing conafnrcflon w f/re <br /> poAamence of conalnrcf/on. That I am aufhorited by fhe owner o/fhfs property to perform the <br /> I 2180 Whic appllcafion!s made and I comply with fhe Sfefe Conhatders Law 18.27 RCW and <br /> oi , II® <br />