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OCT. 3. 2012 10 : 33AM Ngl[RSANT N0. 7478 P. 2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> 2"-a- F f <br /> P_13— cov <br /> PROJECT ADDRESS <br /> sa N w_ 9 E� OtS W <br /> Owner Mall Address City Sta emp Phone <br /> c <br /> Tenant Mail Address City State/zip Phone <br /> �' �1ER15 t rC Aog'>--'. V�KS v SwnlT fi Gkyos� <br /> Electrical Contractor Mail Address city statelzip Phone <br /> State License Number Contract Price of W rk <br /> CSM N.G c,SA nv LO- -yr ice_cc <br /> Proposed Use of Building Contact person (Plan Review) <br /> Square f=ootage(if residential new construction, remodel or addition) <br /> Description of Work to Be Done: "j <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. 50), <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certify that I have read and examined this application and know the same to be true and <br /> correct_ Ali 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 presume to give authority to <br /> violate or cancel the(provisions of any other state or local law regulating construction or the <br /> performance of construction. That/am authorized by the owner of thisAroperty to perform the <br /> work for which <br /> app lication is made and l comply with the State Contractors Law 98.27 RCW and <br /> 296.200 WAC. <br /> r <br /> /0- <br /> Lire Date <br />