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May. 21, 20Ug 12; §3Ph9 FROTECTIOh' 0�'E �vu. 2;39 F. 2 <br /> ( <br /> ELECTRICAL PERMIT APPLICATION <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—wwvv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM 70 4 PM <br /> �q i�(, ��..r��. 'r.,� � : <br /> pf20JECT ADDRESS <br /> �ia�la5�- � ai � l <br /> OwfiBf Mall Addtoss Ciy �n `� SWtelLD� ' Fhonn <br /> �.C��D�^� ��`rY�.�rru�r�i,� �2�t,1.r-�''.� �Q,tt..�2 �v�r�.t- <br /> 7enant Meil Address CIh/ State2ip Phone <br /> �r��,�;�� `[(��� s , 1 ��- l�� u.�{� ��U3 I <br /> •ElecWcal Contra�tor �nan nddruss Ciry SfatelZip �r_����phma <br /> � � n <br /> ��nT�DA r� 33� 3��• C�O -rl ��- <br /> State License Number Contract Price of W/p�rk <br /> v.X�1 0�� . . .�Vl.t��11, 1'����l� � <br /> PrOposed !s of Building Contact Person (Plan Review) <br /> Descriplion of Work lo Be Done: _ � . ��Ll� l/UCi7 ,.�,(�I,(�s� ��� <br /> U <br /> NOTE: \NIRING IN NON-DW[LLINGS IS RERUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE. <br /> CI7Y OF EVERE7T I,OCAL SALES TAX COOE IS 3105 �`*��G�� �' � <br /> I hercby certify thaf l have�ead and exomined U>is applicafion and know tlie same to 6e tnre and <br /> corree(. A!1 provisions oflaws and orrilnances govamrng ihis type ol worlc wlq be complefed <br /> �vhcther spaci�od hemin ornoG The gronh'ng of a pormd does not presume to give authonty to <br /> viola(e or cancollhe provlslons o/any othe�state or locallnw regWatinq cons(ruc6on or thc <br /> pvrformance of consWcGo». That I am authonzed by the owna�of(his proporly to perlorm the n i /� 2/' <br /> �rork for whlch applicAfion is mado a I comply�vlth the S(Ata Contractors Law 1827 RCW And ��� ���/ 7�✓ -f' <br /> 29fi.T.00 WAC. � <br /> ✓ � �� � <br /> 1 f ^ nn L <br /> I � 1W4� <br /> s�fl � '� - .� �r, /�R r�.cd <br /> �. . <br /> cin�..�rn.a.��r; <br />