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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES EoboU--ius <br /> 3200 CEDAR STREET, EVERETT, WA 98201 4 ,.�,I�0(s <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM -DEBIT B CREDIT CARDS ARE NOT ACCEPTED <br /> '"�y/U �'01 C i f=�� ,, ;� l�l-r,_ <br /> PROJECT ADDRESS <br /> \ ��.11�a;s��, v 5�.� 3�/;Y' �/1Lr���,.�, �(/t%lG7_ / l/:U `�7F_Yu/ '�ZT3�6- 7Xe <br /> Owner Mall Address City State2lp Phona <br /> �[�f.� s �c::c ���1., '3yi4 a1L�-(o�-:ri� �'✓r9e=t�7` /�,.. ii ���o� �/zl=Jfa-7ir <br /> Tenant � Mall Address Cily S1ale21p Phone <br /> �P�v�lt%f��1 ��J�[fvut� ri[�l�i� r ! />> 7'M �/Sr� �fU�=i �'�C'A !.�/.� -�( S�Z7C� yzr-3v���c�� <br /> Elecldcal Contractor Mall Address Clry Slate2lp Phona <br /> /11�z..-���_ �s�� , !E, �3zs y,o�, <br /> State License Number Conlracl Price of Work <br /> �',,�1�.,!)rS d <br /> I ,J�c� �C�A�tIS <br /> Propased Use of Building Contacl Person (Plan Revlew) <br /> Descnption of Work to 8�Done: I��' �2�� �� ��I S e� �n. *�� �!���>41 <br /> ' ��(l�ti�.-,. l����, r�J� /c . <br /> � -i <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 hereby ceAily ffinf 1 hnvo read and exomineA fliis epplicafion end know fhe same fo be Irue end <br /> conecl. All provisions ollaws nnd ordinences�ovoming fhis type ol work will be complefed <br /> whefhor specified herein oi noL The granting ol e peimd does nnf presume fo give euUionty to <br /> violnfe or cnncel(ho provisions ol any ofher stafe or local law reguloting consfrucfion or fhe <br /> peAom�ance ol construction. That I nm oufhurized by fhe owner ol tbis propoRy fo perlortn the <br /> work lor which Applicafior;is rnade and 1 comply wifh Iho State Contracfors Law 18.27 RCW end <br /> 296.200 WAC.� <br /> � . �?l-OL <br /> � , _ .� <br /> �Wre Dale < <br /> ��'`� �� � <br /> J <br />