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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES t�/ i/Og <br /> 3200 CEDAR STREET, EVERETT, WA 98201 2 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org ���[� � <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO 4 PM <br /> o�r�r o- al -yoa� <br /> 3 Do3 w����o l�'`�• sou-trt �n�7,E o � .?�l►�� <br /> r V([ICIG'P'f- �)th- • � <br /> PROJECT ADDRESS <br /> Owner Mall Address Ciry SUle21p Pha�e <br /> Tenanl Mall Address ���Y S�a�e�UP�O P�' <br /> v)� <br /> .��.,.� �c� �o P,�� ?�9 /�A�VSYi� �e�• �Z'10 <br /> Elecldcal Contraclo� Mail Address C�ty SWlefZip Phone <br /> � a�;� =- <br /> Slate license Number Contract Price ot Work <br /> Proposed Use ol Buildiny Contact Person (Plan Review) <br /> Description of Work to Be Done: �i���"`"�"'� �"_ `� �"'� ��� @ �` ���� <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 TAI(CODE IS 3705 1 <br /> I hereby certily fhaf 1 heve reed end oxamined this epplicafion and know fhe same fo be true end ��j q b(./ - (,� <br /> correcf. All provislons ollaws end ordinencas goveming thls type ol work will be complefed 4�� I <br /> whefher specified herein or not. The granfing o/a permlf does nof presume to give authoriry fo <br /> vlolafe or cancel fhe provislons ol any ofher state or laal law regu/eting consfructlon or the <br /> per/ormanco o/construcfion. That 1 am authorized by fhe owner o/fhls property fo perlorm fhe <br /> work/or which applicatlon!s mede and 1 comply wifh fhe Sfefe Confractors Law 18.27 RCW and <br /> 296.200 WAC. <br /> Sl�re��� Dat�/l D� • <br />