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Dec. 3. 2010 1U:49AM No. 6241 P. 2 <br /> ; t <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - rAX425-257-8857—www.everetlwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �Z �3 �� <br /> �/O/�-D3, <br /> I Ilo2��er���en �a �� ��� � �,aoy <br /> PROJECTADDRESS <br /> Co lu,�b; �, �ctn�c I��l1,�h o�S `�a\b -��kh �. , lm.�.�,�o� q�y°1`i <br /> Owner MallAddress Cily State2lp Phone <br /> (�ol�trv�b�a Qan� 1102 ��4.�A�reCn �a� �;�e�e.�e. �� ��ro�l ��� - Sg1o� <br /> Tenant MallAddress Cily Stale/Zip a� Phane <br /> goo� ��p.��- ���� s�+h �e.�. ,�����:Q l���1�3�3 8u�-�o3� <br /> Elecirical Conlractor Meil Addreas cuy ' (� StatelZlp Phvne <br /> ��nN �G�LC� CJ�. "�lYl � �� `� a �� <br /> State Licensa Number Contrac!Price of Work <br /> �Q,���-1 �, ����n <br /> Proposed Use of Builcij g Contact Person (plan Review) <br /> V <br /> �',n C n,, I�,\ C �f� <br /> Descrlp�lon ot Work to Be Done: ����+ t�'� \J l..I�t�NJ 1 f`(� v�. �\L.m <br /> \���9�.c� c�.Il �C' ���X\.QS � � `�0�.�-G <br /> 1.5�� �N 1'�-c�c ��� . <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE, � r� D D <br /> J � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 heraby cerlily fhat 1 have read and examined Ihls spplicelion and know Ihe same fo 6e true and <br /> correcl. Afl provlslons ol laws end ordinences povernuig fhis type ol wak wil!be complotad C� ��2' a� <br /> whether specilied herein or noG The granfing o/a permd does nof resume to give aufhorily to <br /> violate or cancel the�rovisions of any ofher sfate or local�aw�eguPting construc(!on or the <br /> peAwmanca of cons ructron. 7hat I am aufhorized 6y fhe owner of(h/s proper(y to peAorm Ihe <br /> work for which sppllcsllon Is mede and I comply wifh fhe Sfa(e Con(ractors Law 19.z7 RCW and <br /> 286.200 WAC. <br /> ,C.C. c��(`�.+, C.. ��L `� 2� ID <br /> 5 gnaWre �— <br />