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Dec. 1. 2010 12:51PM No. 6190 f. 2 <br /> � � <br /> �� ELECTRICAL PERMIT APF�LICATION <br /> C17Y OF EV�RETT PERMIT SERVIt':ES <br /> 3200 CEDAR STREET, EVERETT, WA A8201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> A�PLICATIONS ARE ACCEPTED FROM 8 AM TG 4 PM <br /> �Z"���(7 <br /> � � <br /> j I I I`��. �v�rz,rP,ea,n ��,�.� C�o�z-- <br /> PROJECT ADDRESS <br /> ��,�v�l�'a���a,��' � n���1� `���, �w ��Iqq <br /> Owper MallAddress �`�� Cily St9le121p Phone <br /> V <br /> Cd-j��i A � �/ lI I�C��e1,r�e,�L����--�rer�-�l- �� q� <br /> Tenanl Mail Addres9 Ile; y StalelZip Phone <br /> �����c;� »�I� �'�� �-�u , ,� � a��3 a�,�a <br /> ElectricelContraclor MeilAdtlress Iry �Ip Phone <br /> � ������� � ��� � <br /> Stala Licansa Number Contrect Price ot Work <br /> ��'�,�... (k��'i'n1��C�l1-I <br /> Propose Use of Builtling Conlac Person (Plan Revlew) <br /> Description af Work to Be Done: �L � Q. � <br /> ,� � 'e � <br /> �' �;Nr�\� o�1.� i-4r o� �nrc1 I �rr.�tanf�� P,�n se,nstsrs <br /> NpTE: WIRING IN NON•DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE I$3106 <br /> I here6y certily that I have read and examined lhis applicati�n and hnow the samo to 6o trua and � <br /> corrocf. All pruvisions ollaws and ortlinances governing th�s(ype ol�vork will be complefed Ll��'L— C�� <br /> whefher specil/ed herein or no:. The pienlinp ol e pe�m�t does notp resume to give aufhonty to <br /> violataorcancelthe rovisronso�anyothe�stateorfocallawregulatingconstructicnorfho <br /> perlormsnce ol consPruc(ion. That I am aufhorized by Ihe owner o�Ihls propeRy fo peAoim the <br /> w.ork lor�vhlch app6cstion Is made end I comply with the Stafe Contracfors Law 18.27 RCW and <br /> 296.200 WAC. <br /> �- ��.. �, «�I � � <br /> Signature —�ale <br />