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� , � <br /> ELECTRICAL PERMlT 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 ACCEi�TED�ROM 8 AM TO 4 PM `�"a'�"'� z <br /> �.��,� -o 0 <br /> G/ � � �i LSv��2�p��N w� ;� <br /> PROJECT ADDRESS <br /> � <br /> Owner Mall Address Clh• State/Zip Phone <br /> a Fc � 8�a �r�� � = ����, ���s w� s- wr� 98ao.; <br /> Tenant Malt Address Ci y Stale2ip a53 �`a one <br /> —r <br /> 5>s 3 <br /> 5�,� - i�c cs��-�;��� ,.�tic 7os-� S e��a „ s� �dti; w� 9803� <br /> ElectrfcalContractor Ma➢Address City Slate2ip Phone <br /> S�'� i/a [� T C� � �� ��c.l � �b�0 <br /> State License umber Contract Price of Work <br /> Co�E°' lv�CK;ivyo�l <br /> 'v/�' ,9.5;� ��7 �$ 5�c�. <br /> Proposed Us of Buitding Contact Person (Plan Review) <br /> Descriplian of Wark la Be Done: �,3�C n �'�.�i� � /�o S S il�t`i n n. 4 �}'�Cl, S,-r�T� 'o�✓ <br /> ��' Jl uc � c '� � ,';5 i�-Nc� APOQo� � � � (�j ca <br /> �nNNG'G� ONS <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. �7 5(� <br /> � � <br /> CITY OF EVERETT LGCAL SALES TAX COUE IS 3105 � l ZOy —�O O <br /> 1 hereby certify thaf I have read and examined thls applica�lon and know the same to be true and <br /> correct. All provlslons o(laws and ordlnances govem(ng th(s type of work wi116e completed <br /> whether speci�ed herein or nof. The yranfing of a permit does not presume to give aufhoriry to <br /> violate or cance!the provisions o(any ofher state orlocal law regu/ating construction or the <br /> performance of consfruction. That 1 am authorized by the owr.er of thisproperty to perform fhe <br /> --work-Ior•whicMep ' elion•irmede�and•1•comply�wifh•the-Stete�6ontrecforsEaw-18:27-R6W-an <br /> 296.200 WAC. � <br /> ��,.- 1�i � ��� �oia <br /> —� Signalure � Gate . <br /> � S'ee avnen,�,eo�a�� I� ���G►'l a �rv� <br />