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10/21/2013 14:54 253-631-7754 PROVIDENT ELECTRIC PAGE 02/02 <br />• • <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 - m-,w everettwa. org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />Aaa- <br />PROJECT ADDRESS <br />��x1�Y�� <br />Owner <br />c� <br />G N/'�Sa�z <br />y25-7�C8-9kL <br />( <br />^au ada•ess <br />City <br />Stale/LP <br />Phone <br />Tenant ti+ad addrrs <br />Cry <br />StatelZIP <br />Phone <br />Contractor Mad Address <br />LBoV_ s£Sta�G2 <br />Stale Ucenso Number <br />d7 <br />Prop05od Use OI Bull ing <br />Description of Work to Be Done <br />VOTE_: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE <br />CITY OF EVERETT LOCAL SALES TAX CODE 13 M05 <br />_(O0571 ZSS-631-41 <br />StaleJZ,p Phone <br />Contract Price of Work <br />Aact Per (Plan Review) <br />FEE <br />I hereby certify that I have read and eaammed this application and know the same to be true and �(� I O ` I G <br />correct All provisions of laws and ordinances govemmg this type of work will be completed ✓ <br />whether spearred harem or not The granting of a permd does notpresume to give aufhonfy to <br />violate or cancel the provisions of any other state or local law regulating construction or the <br />perl0rmer:e of conshuceon That l em authonted by the owner ofmrs roparty to perromi the <br />work for which appbcatron is made end I comply with the, State Contractors Law iB 27 RCWand <br />296 200 WAC. <br />1`3 <br />