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12/07/2010 03:59 4253373006 ALPHA OMEGA ELECTRIC PAGE 02/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, VIA 98201 <br />425.257.8810 - FAX425-257.8857-vnw/.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM c /D /2 -053 <br />/ODt ,� vim` Lc>l� 9fEzd'3 <br />PROJECT ADDRESS <br />Owner �p Mail Address City StateZp Phone <br />J5l1e+✓ui ict 04' <br />Tenant -Mall Address City State/Zip Phone <br />,4y-Ab-q- om "A,,, A,, 9s s/ zgt&.t Ak. Sf sk-evel Lo,* 98zoe- <br />Imloctifical Contractor O Men Address City St■t"P Phone <br />2r s<a1 <br />State fcenae Number Contrail Price of Work <br />22.7— 2-40"`7 <br />Proposed Use of Building Contact Persor, (Plan Review) <br />Description of Work to Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />131: IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL BALES TAX CODE IS 3105 r� <br />1 hereby con/fy flint I have read and eramired this application and know the same to be true and <br />correct. All provisions of laws and ordinances goveming this rypo of work will be completed <br />whether specified herein or not. The grantin of a ppem;;f doer ni ppresume to give euthonty to <br />violate or cancel the pprovision of any other late Or local low repufating construction or the <br />performance of construction. What I am authorized by the owns of this mpeny to perform file <br />PBB 1f8r whiIVAt application is made and I comely with the State Contractors Law 18.27RC W and <br />5,9nature Date <br />