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09/26/2010 03:00 FAX <br />Q 001 <br />Y r <br />ELECTRICAL PERMIT APPLICA <br />TION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT. WA 98201 <br />425-257-8810 - FAX 425-257-8857 — voMtv.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />PROJECT ADDRESS <br />Owner Mail Address City State2lp Phone <br />Tenenl 1 IIAddreas CITY Slele/Zip 7�-On7r2 <br />ve <br />13Sso 3 C+`�tANe- Seas u1tN 2F1oxS_ <br />Electrical Contractor Mao Address City State/Zip Phone <br />13me,0.�G(Z'5, eo & o <br />fate License Number Contract Price of Work <br />t Ti�1 <br />Proposed Use of Bvng Contact Person (Plan Review) <br />Description of Work to Be Done: '- `= s �inle, - <br />i�,j)_�c,t) �oo� TOt? <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. [//l <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have reed and examined this application and know fhe same to be true and <br />correct. All provisions of lows and ordinances governing this type of work will be completed <br />whether speed heroin or not. The granting of a permrf does not presume to give authorityto <br />violPale or cancel the provisions of any other state cr local law regulating construction or the <br />performance of cons ruction. That I am authorized by the owner of thls pproperty fo perform the <br />work <br />2forr which application is made and 1 comply with the Slate Contractors Law 1 s.27 RCW and <br />posture _4 �z Et4z <br />"t" <br />r <br />