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/ -- , <br /> ELECTRICAL PERMIT APPLICATION '� <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERE7T, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 -www.everettwa.org il <br /> APPLICATIONS ARE ACCEPTED FROM S AN�TO 4 PM -OEBR i CREDIT CARDS ARE NOT ACCEPTED �I <br /> � <br /> �/O <br /> /����� �112 � <br /> PROJECT ADDRESS I <br /> y�/o �'Jr"'1R� �� C� ��� 'i1 <br /> .r�.-�- /til..l'�s s�awnc (y7�) zs2°�io i <br /> Owner Mall Addrose GH <br /> 1 <br /> Clty StateZP Phar � <br /> Tenanl AAail Addroae I <br /> /o rG zz. nu°�"r�C '�3°2 E� fil4 R'drZe/ 'S�S•U(o 3 3 f <br /> � Sfats/7JP �� I <br /> ElecMce�ConVeda� Mall Addrcas ��' ' <br /> ,' <br /> A7 yC�o ' <br /> �"/�-C�L- A�* Contrect Ptice o(Work <br /> State Lice�se Number <br /> ,n �/ /� <br /> r Contecl Peroon (Plen ReWsw) <br /> Proposed Uae of Building <br /> Descriptlon of Work to Be Done: A'1'c� �t � " r <br /> NOTE: BERN�CEWAYS MC OR ACICAB EUIRED TO <br /> FEE <br /> CITY OF EVERETT LOCAL SALES TAI(CODE IS�105 <br /> 1 hereby certlfy fhet 1 have reed and examined fhls eppllcaflon and know the same fo be true end <br /> conecl. All provislons ollaws and ordlnances poveminq thls fype op/xrork w7��be comp/eted <br /> vloleteeor cancel�he prowslons�ol any othe�i sfate or local�w repuleNnp construc lon otr thre fo <br /> peAormance o/con�sc�No�n�Is mehde end 1 comply wlthY�he Stafe Confre�cPors�w iB.��RCW and <br /> work lor which app <br /> 296.200 WAC. <br /> ��� '�'�� �o�� � — <br /> Signature <br /> �a{G7-Oa& <br />