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02/20/2013 WED 14: 16 FAX 360 IIIII 0287 MILNE ELECTRIC 0003/004 <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 /> (e/ Tazel z7c:- 7V2) <br /> PROJECT ADDRESS <br /> ' ? C11P �o / 3707 5 -A-TR.-E (-A q l,7Y-aa6 <br /> Owner Mail Address City State/Zip Phone <br /> Tenant Mail Address City State/Zip Phone <br /> Electrical Contractor Mail Address City State/Zip Phone <br /> State License Number / ,/ Contract Price of Work <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Done: ti��rr-�o C%�•2• y ���v � 2 5- <br /> rle-C) ./ <br /> r <br /> 4/ <br /> ..2' i'r`is fZ ! ` /7 e-,✓ 7,r""-,'foa _ i^ <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. / 7 C? , <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> /hereby certify that(have read and examined this application and know the same to be true and � <br /> correct. All provisions of laws and ordinances governing this type of work will be completed ( ._13 `"7 <br /> whether specified herein or not. The granting of a permit does notresume 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 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 RCW and <br /> 296.200 WAC. <br /> t2 A??4,2 <br /> Sign ture <br /> 9 Date <br />