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i � <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES �Jy//2 <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org C��s-03� <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> ��C� Li�.1�+F02�1(� S 1 _ <br /> PROJECT ADDRESS <br /> G31ulC.At�i JrOs�OI.WU�1 1'bALaL+co�.��aST �vp�T µ�A . �f�t$�1 �cF7S �i`6`d -�7 <br /> Ownor Mall Addiasa City Slate/Lp Phone <br /> CN�WlsMk A.DVc7��`I 150�1 G4uFoErJ�+�15,-�vCR��'tT UJA �1�S1A� �4�'s�"'��Sb �1 7 <br /> Tenant Mall Addrese City State/Zlp Phone <br /> JOHdaS�c.-1 �.+.G4+a�-l�ut� QU.�-Il.`ZS WOGO�w7Vi�� v-�A . C1�01a <br /> ElecMcalConlraclor MallAddresa Clly State2lp l�.���\Ph??�� <br /> L <br /> .• <br /> .�Z5o . <br /> Slate License Number Canlrecl Price of Work <br /> Proposed Use o(Building Contacl Person (Plen Review) <br /> ` r <br /> Descrlplian ot Work to Oo Dono: �2F_�f�.TE_ -C�-'.EF-+�'�aS1�4Z� �- 1 o a wk�T <br /> P�.MPti C�+,� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E � <br /> BE IN RACEWAYS, MC OR AC CABLE. �C� <br /> CITY OF EVERETT LOCAL SALES TAX .ODE IS 3105 <br /> 1 heroby certily fhat 1 have reed mid examMed Ihls appUcetlon end know fbe sama to be true end �) �Q S- p 3 � <br /> corrt3cf. All provlslons ollaws and ord(nances goveming flils type o/work wlll be complefed <br /> whefher specifled herafn or nof. The grantfng o/a pemut does not res�me fo give eufhority fo <br /> vlolafe or cancel the provlslons oI any otfier sfa(e nr local low reguPetlnp conshucflon or fhe <br /> perlomiance o/canslnicflon. Thet I em autho�ized by the owner ol fhls property to perlorm fhe <br /> - - work-/a-whWh eppNoeNon Is mede end I comply with Iho-Sfate GontrectNslew-}B:Pi�ROW�end <br /> 29G.200 WAC. <br /> �'�" '� � �I�'Ila <br /> Signature Dete <br />