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07/22/2009 07:31 4254885289 PAGE 01/01 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />144Z x t+� w/ty -tf-/os <br />PROJECT ADDRESS <br />Owner Mall Address City Slata2lp Phone <br />LS <br />l tzEASue45 1svt,J C�, ► 4uZ Sc E.uae-E-,z' tWcu.- wg-`k q$Zo fl 5 satFF3 <br />Tenant Mall Address City State2p Phone <br />7. S3 <br />�Yy�uuzrty 5a=v_r�C3 ll8zy�.'. t;�P.�w/as'�lor P,:7kti� ✓ti�1- 9a�r�� 3}a--tl�� <br />Electrical Contracto Mall Address Oily State/Zip Phone <br />Iht7� i)t3'ZU5 /z00.00 <br />State License Number Contract Price of Work <br />r�� 1JA Zs3.3 fi� -tlt,4 <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Dane: S`/STtx( <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 15 3105 <br />1 hereby certify that I have read and examined this application and know the some to be We and G cl U Z U r6 <br />correct. All provisions or laws and ordinances govemmg Cris typo of work will be completed <br />whether specified herein or not. The granting of a permit does not Presume to give aufhorltyto <br />violate or cancel the previsions of any other state or local law rogutating construclon or the <br />performance of construction. That lam authorized by tho owner of fhis ropeny to perform the <br />wodr for which application is made and I comply with the State Contractors Law 18.27 RCW and <br />296,200 WAQ. <br />0% <br />s Fo onto <br />