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04/Oa/2012 11:28 FA% 425J598994 Ever6reen Securlty f�J002 <br /> \ ` <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIl' SERVIC�S <br /> 3200 CEDAR STREE7, EVERE(7, WA 98201 ' � <br /> 425-257-88"0 - FAX425-257-8857-www.everettwa.org N'3- Z <br /> E izoy-o+`f <br /> APPLICATIONS AFtE ACCEP7ED FROM 6 AM 70 4 PM <br /> �YCta-2-Lcst' <br /> Ev�t2C�R --- +Nl� — �.s.e� <br /> PROJECT ADDRESS ��'`�yg_c� ��� <br /> �a,• <br /> � �, ,unG�l�1 0� �v2�P,E� '-�81� Ea���t1 C;�� �'�l <br /> OwYi Mall nCCnss CI SGIa21p P�ono <br /> Tenant MallAddress �.1.,10` ��Y S�t�P e <br /> / -i�+ t <br /> �l�� C�trP� ►� a$2o���$ <br /> Electrical onhador a Addresc Gt SteteJLip F'hone <br /> �v��c�st la��: _____ �q�o, � <br /> Sfate LJcense Numher Con'�act Prica of Work <br /> C:c�mrne�-�.�. _ c' mu�.n-�.�- <br /> Proposed Use ot Building Contact Person (Plan Review) <br /> pescriPtlon of Work ta Be Done: ��1Mi V� �� � -��V� � <br /> � , <br /> � {r� 1 A �hl.sr� <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABIE. <br /> CI7Y OF EvfRE�7 LOCAL SALES TAX cODE IS 8706 1^ <br /> I here6y ce�tily thaf I haw read and examined fhis epplkallon and Www Ure seme to be frue end � I o!Qy — C� ��-{ <br /> ooirect All provisions o//aws and orrlinances po�eminq fhis type o(work will be completed <br /> whefher speaC�d herein or noG Ttre granting of a peimR does rrot sume to givp aulhaity to <br /> violate or cancel fhe provisions o/any other state or focal!aw regu�ng conabucGon or fhe <br /> performan (oonairucUa�. That 1 am authorized by the owner of this property fc perloim the <br /> 296k� AC. ��'��ion is made and I comply wifh the Stele Contrecrors Law 1d27 RCW and <br /> 3 t � <br /> Slgnature ala <br /> � <br />