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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 />�Uv� nl Br�o�1.,,o,u, A-3 <br />� <br />PROJECT ADDRESS <br />��.� �'�'T17 <br />Tenant <br />Mall AAdrass <br />Meil AAdreas <br />city <br />� <br />Clty <br />State2lp Phona <br />,� �4 987_O I <br />Slale2ip Phone <br />�v�,c.�,,,wef Ci 15 AIE NWY fi V�q�,y�u�,ef uJA 4B6LS 3�0 643 477, <br />Elecirical Coniraclor Ma�l Addreas Clty SIa�e2ip Phona <br />�IAnlc,os 1�i7�['a <br />State License Number <br />A .1; ..�I C. „MYV� er .� 1.I <br />Proposed Use ol Building <br />Description ol Work to Bo Done: <br />'��uwi v�nt .ca �iun n1�'nct <br />NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3105 <br />Z90C� <br />Contrect Pdce of Work <br />ti&i� S-FtN ✓VI <br />Contacl Peraon (Plan Review) <br />3�0 643 y773 <br />I he/eby certily fhef I have read nnd examined fhis eppLcnfron end know fhe seme to 6e frue end <br />correcf. All provisions o/ lews en,f ortlmnnces govaming fhis fype o! work will be completetl <br />whefher specilied herein or nof. The grnnfing ol n pennrt does nol presume fa give euthonty fo <br />violafe or cancel fhe provisions ol eny olher slare or bcal law reguleting consfmcfion or the <br />perlormance ol constn/cfion. Thef 1 em aufhonzed by the owner ol fhis p/operty to peAorm fhe <br />work /or which epplicafion is made end I comply wifh fhe Sfefe Con�mcfors Lew iB.27 RCW end <br />'195 200 WAC. <br />< <br />FEE <br />� �r��-< <�� <br />