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NOV-16-2005 11:23 FROM:PERMIT 4257756315 T0:1425257BB57 P,2 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257.8810 - FAX 425-257.6857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 5 AM TO 4 PM - DEBIT t3 CREDIT CARDS ARE NOT ACCEPTED <br />q1( cl3 �J Sf St - <br />PROJECT ADDRESS <br />61 i4? CUeas Ct l(e 99`6 GtJ49F 2aj_ 3.V7 <br />Owner Mall Addrr.a City State.zli Phone <br />jj41h_V_ <br />Te..iant Mel Address 2lvr� r, Glv Phom <br />^Slala2lp <br />Electrical Contractor Mall Address Gty Ststarzo Phone <br />b,1'#JI116_,197/oy 757, — <br />State License Number Contract Price of Work <br />P -- 1-41?dw SL M;L_71__�/1-rz <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: sy-V0 <br />NOTE. WIR114G IN NON -DWELLINGS IS REQUIRED TO FEE <br />BF IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />1 hereby certify that I have read and examined this app3catlon and know the same to be true and <br />correct. All provisions of laws an tld ordinances governing this type of work will be completed <br />whether soeci6ed harem or not. fie granting of a permit does not to tc <br />ppresume give authority <br />violate or cencel the provisions of any other state or local law regulating conslnicfion or the <br />perlarmance of construction. at I am authonrad by the owner of this property to perform the <br />work for which application is made and) comply wdh the State Contractors Law 15.27 RCW and <br />296.200 WAC. <br />�l�y�u.Lc-�TI�IGyicS-/ 1 /'/I <br />V ' SlgnaNre - au <br />i <br />