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( <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 /> `f&�G �Gc� �✓� <br /> PROJECT ADDRESS <br /> —_!��/l�� �/Lil.ST <br /> O�vner Mall Addroas Clty Stale/Zlp Phona <br /> Tenanl MallAddrese City Stale/Zip hZs <br /> �{ <br /> �1r1-�virr-- �t�c.T /�v �3o.t z`%cx� �(/r�tcylT u�14 98Z/3 zSz-Ff <br /> Electrical Contractor Mall Add�ess City Slate2lp Phone <br /> G✓u.a , �i2�3cc- ��'"`—' 9cm"-' <br /> Slele License Numbor Conlract Pdce o(Work <br /> Proposod Uso ot Buildin8 Contacl Person (Plan Review) <br /> Description of Wark lo Bo Dono: ��OUJF /��/�CE �SGY�� 5 y �T <br /> ��a_-� l <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY Of EVERETT LOCAL SALES T!U(CODE 13 3105 ��j <br /> 1 hervby cerf!/y fhaf 1 havo read end exemined this epplicetion end know fhe seme fo be hue end � I (�J `-'O � <br /> correct. All provislons ollaws end ordinences goveming thls type ol work wlll be complefed � <br /> whothor specified herein or nof. Tho pranfinp ol a permit does nof resume fo glve authonfy fo <br /> vlolafo or cnncel fhe provlslons ol eny ofher sfefe or local law reguPting conshucflon or the <br /> perfomiance o/consfruction. Thaf I am euthorized by fho owner o/Ntls property to peAorm fhe <br /> wo�k/or whlch applicafion fs mede and 1 comply wlfh fho State Confmc(ors Lew 18.27 RCW end <br /> 296.200 WAC. <br /> �;;�lr.���-- 3���/rc � <br /> SiB��ature Dale <br />