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l <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 /> �,�, 2 �O �I� C-s►'L�d ���' <br /> PROJECT ADDRESS <br /> ��1 D i S sv�`r� <br /> Owne� MallAddress �;ty State2lp Phone <br /> ��l���L�� 1 '�1�1Z� �79L� <br /> Tenant Mall Address City State2lp Phone <br /> ���SS�►v ��E L (?o• �=�`� � ���TC us4� �20� 33�2� <br /> EleCtdcal Contractor Mai1 AJdress City Slale/Zip Phone <br /> �{L�SS� � l ���Z— ��Oa R aC� <br /> State Liconse Number Contract Price oi Work <br /> V � � �� �` c�� L�J <br /> Proposed Use of Building Contact Person (Plan Review) <br /> Description of Work to Be Dnne: ��1-�-"--1 !� 2 —��.( �1 I� L..�(-T}�-1��� <br /> � �� (J 1 •- F 1.�=�� L.l l�1-��T �.l (�C � ! �' <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 IS 3105 <br /> 1 hereby certify that I have read and examined fhis application and know the same to be true and <br /> correcL All pmvisions ollaws and ordinances goveming ihis type o(work will6e completed �'����� -��� <br /> wiiefher speafied herein or noL The granting o/a pennd does nof presume to give authonfy to <br /> violate or eancel the Provisions ol any other stafe or local law regulating conshuction or the <br /> pe�formance of construction. That 1 am aufhonzed by the owner of this property fo pedorm the <br /> wo�k/or whi pplication is made and 1 comply wifh the State Confractors Law 18.27 RCW and <br /> 296.200 W C <br /> ; <br /> � � 1S <br /> al re ate <br />