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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERFTT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.evereltwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM Tn 4 PM �Z � <br /> w cfls wo ► �cio��-oio <br /> � I �' Pu � � . � � �1/' i�- <br /> PROJECT ADDRESS <br /> `t- 4r� s ,- s� ,� ��� iL�r� � rl 4t� ���� �'l � <br /> ,� ,� a K,�A ,2 , z Z , , <br /> (hmer Mall Address City Slale2lp i'hone <br /> N � .�.' E <br /> Tenant Mall Addreas Cily State/Zip Phone <br /> n� .-NE <br /> EleclrlCal Contrector Malt Address Cily State2lp Phone <br /> Stale Llcense Numbar Contracl Price oi Work <br /> � I /J � l �- 1 .� �� I L� ��-�-S ll)i����l�. — <br /> Proposod Use o1 Bullding Contacl Person (Plen Revlew) <br /> 1 � �ANE 1 I � 2 .�v�1 <br /> DescdpUon of Work lo Be Done: �J �� �2 �� i1� - <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF E4ERETT IOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certfly fhnf 1 have read end exemined fhls eppUceflon end know fho same fo be frue and <br /> corrt+cf. All provfslons o/laws end ordlnances goveming fRls fype of Nrork will be complefed <br /> whefher spocllled hereln or nof. The granfing ol a pemuf does nof pres�me fo glve aufhorify fo <br /> vlolate or cancel(he pmvlslons o/any ofher state or locel law regulafinp consfructlon or the <br /> peAormance ol constructfon. Thef 1 em eufhorized by flie owner o/fhls property fo peAorm fhe <br /> work lor whlch eppllcafion is made and I comply wlfh the State Confractors Lew 18.27 RCW end <br /> 296.200 WAC. � /0/ 1 _ D � � <br /> / d <br /> �� --� �v Ti � � ( ., <br /> Sipnature �ef T <br />