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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDP.R STREET, EVERETT, WA 98201 c� — � q - Oq <br /> 425-257-8810 - FAX 425-257-8857 -www.everetlwa.org � O �D 5, 09� <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � (oZ.Co G-IEsrti1V.T `�TIz�.T- <br /> PROJECT ADDRESS <br /> ��21An �DA�11S <br /> Owner Mall Addresa Clty Slale2lp Phone <br /> Tenant MallAddress Cily SWte21p Phona <br /> 425' <br /> STr-.(��hiC. [-iEcTR��- �0 6fJX 24'4 1�a�D��l�i�� 98�1Z. 48to•4722 <br /> Eleclrical Condocto� Mall Addross City SlalelZlp Phone <br /> STEe-�..EL�9 Sk;H `-� 240.� --� <br /> Slate Llconse Numbcr Contra.t Pdce oI Work <br /> Si r�L-�� Fcv11�-� �esii�lcz E.v Zoco �93 415z <br /> Proposed Uso ol Building Conlect Person (Plan Reviaw) <br /> Description ol Work lo Do Dune: '1i��,_GQ�7E CO(L-'�LT�Gr1S P�fZ I If"1 �S 1�57�c o <br /> P�QoRI <br /> NOTE: WIRING IN NON•DWELLINGS IS REQl11RED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> GTY OF EVERETT LOCAL SALES TAX CODE IS 3105 �C�qoS- oq 8 <br /> I hereby cortily fhot 1 havo reud a.nd exeminod fhis epplicafion end k�n N tho seme to be fruo end <br /> corrocL All pravisions ol laws end ordinances gnveming fhis type ol worlc wlll be complefed <br /> whefher specl6eA heroin or not Tho granting o/a pennd Aoes nof presume fo glve aufhonty fo <br /> vlola(a or cpncol tlie provlsions ol any ofher stefe or locel law regulefing construcfion or the <br /> pedormence o/consinicflon Thaf I om aufhodzed by fhe owner ol fhls pmperty fo peAonn fhe <br /> work lor which applicnfion is mado and 1 comply wifh Nie Stafe Conhacfors Law 18.27 RCW end <br /> 296.200 L1'AC. <br /> _�-F' � 19 � <br /> Signalure - Dat <br />