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FEB/07/2013/THU 11 : 38 AM WPCS Int' l - Seattle FAX No, 425-41 ,9-2121 P. 001/001 <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 /> 62 6 b 11?E- <br /> PROJECT ADDRIESS <br /> Cosi'Co goX Sea"/e, AvI4 VO/z 4/ <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> WPlS 1177'tMaIZi 1291 152411 N£ 90 4- 5-54 d3e�rr�o�% hiA q'do5z <br /> Electrical Contractor Mail Address City State/Zip U25- 41 PoL(o7 <br /> 6o/ - 555 -3 3 )A h csl, i2M/ f2l5oo . 00 <br /> State License Number Contract Price of Work <br /> Z aw va /7W 9r (cfin�rd s Alonzo Rat-eb- - .— <br /> Proposed Use of Building Contact Person (Plan Review) <br /> 15, 000 <br /> Square Footage(If residential new construction, remodel or addition) <br /> Description of Work to Be Done! �/2 f �f_ CC TV <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE ^^� <br /> BE IN RACEWAYS, MC OR AC CABLE. W� <br /> CITY OF EVERETT LOCAL.SALES TAX CODE IS 3105 <br /> I hereby certify that I have read and examined this application and know the some to be true and 0 / O�� <br /> correct. All provisions of laws and ordinances governing this type of work will be completed <br /> whether specified herein or not. The granting of a permit does not ppresume to give authority to <br /> violate or cancel the provisions of any other state or local law regulsting construction or the <br /> performance of construction. That I am authorized by the owner of this property to perform the <br /> work for which application is made and I comply with the State Contractors Law 18.27 RGW and <br /> 286.200 WAC. <br /> Signature Date <br />