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1�/29/20�7 10:39 4253538934 EVERGREEIJ SECURITY PAGE 02/�2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STRE[T, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857-www.everettwa.org �� _'t �- 67 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��p��� ..-��� <br /> .�I a� C��r�y A�tr�. �.lti� r� c-i- <br /> PROJECT AppRESS <br /> �r'(�+�h'stC���O�''. ��l Ru.�Jrn.r' G�c-c,� 1(�d <br /> Owner hta darese eiN Slale2lp Phone <br /> l��h�.�l�ewizt� ('�vt�-es� �-me-- a� C�a�r-� , <br /> Tenant MallAddross City State2lp Phone <br /> �1JP�t?�Yr�-� c�C'(.u.f?�t,'fl/I �I l� I' �1�-U �10( �f�gZ03 <br /> Eieclrical treCtOf MailAddress C�ry State2ip L.�-a�.--P�hAg. G�� <br /> T r>J <br /> ��'�C'as�► � a�2• � I 3o-7. aD <br /> Slate License Numbe� � Contrad Price of V�brk <br /> ��_ �L('�P_ �Z(,�`K S <br /> Pmposed Use of 6uildi g ^ � Conlact Person lan Review) <br /> De cription of Worlc lo Be Dane� �Q-�� fNtiWl � �� <br /> vl� � 0 3 <br /> r � , <br /> NOTE: WIRING IN NON-DWELIINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. � ���Q <br /> �(i <br /> CITY OF EVERETT LOCAL SALES TAX CO�E IS 31U5 <br /> 1 hAreby cartily7hOf I havo read and exsminpd fhis applicafi0n and know fhe Same f0 be frup and <br /> co�cl All pmvisions otlaws end o�dinancps govemmg fh�s fype o/work�5r11 Ce cromp/eted <br /> whefher spoci�od hercin ornoL The granfing o1 a permd tloe5 nof msumo(o give authonty tp E Q7 �Q-� J� <br /> violt,teorcancol(he provisionsofenyofherstafeorlocalfa�v�equPsrinyconstruc��o�or�ho <br /> porfem,fonce o/cpnStrt�Gion. Th2f I am authon:Otl by fho ownerOf this propprty M perlorm fhC <br /> �vorklor u�nich applicsfion is matle nnd I cvmply�vifh the Sfate Contractors Lpw 18.27 RCW end <br /> 2 .200 WAC. <br /> ; I <br /> St aturo l� � �� <br />