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�2/O1/2007 13:13 4253538934 EVERGREEhI SECURITY PAGE 01/01 <br /> � � <br /> ELCCTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D CEDAR S7REET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857 —vnvw,everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO a PM <br /> �22 I �Ve.ve_+� �/� , <br /> PROJECTADDRESS � �� 9 �� �/�i� .� �Cc ���Dc� <br /> � <br /> ��P��UYG{J I�S1�Oih � G!Q S<S�mo �1/Qye$ Wg ��Df��- (�� <br /> Owner MallAddreyv Giry State2lp Phona <br /> c�l�X <br /> renant MallAtldress CIH Stale2lp Phona <br /> E�/PY�V�P11 ��Cll►"r�llil�N,���1�1i��la/GlU SIf IUc',Y�InVP$ IN�aD.(K �i2 ?AfS-�� <br /> � / ' / � � <br /> ���5�1121_Z ���Y' y�S .5.��' �= _ �pq�.m� <br /> State License Numbar Contraci Price of Work <br /> Proposed Uso of Building ContacDl�e on (Plan Review) <br /> Oescription of Work to Bn 0one: V � � — � S'���y� S�S.fI'-�1�1 <br /> NOTH: WIRING IN NON-OWELLINGS IS RE4UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 . <br /> l he�by certily(hat!have naad end examinoq fhis applica(ion ond know fhe Sema to be 7ue and - <br /> CorrecL AI!pravlsions o//ews and ortllnunces govern/ng this(ypa o(work will6o epmp/oted I <br /> whether Specdied hereln or nof. 7he grnnfing of a permrt does nof piesume ro glve euthonty to <br /> vio/ato o�cancel the Arovisrons ol any other sfate orlocal law regulgting constrtmtlon or fhe <br /> Nrorfk�o avhrch appl caf/oCn/s ade snd I comply Kd��7he 3tate Co(recto s:aw 19,�RCW and <br /> 2sB.200 WAC. . <br /> �Y(,�h1I� ZII / U-7 <br /> sig��,•_ _ �. <br /> Del ' �� � <br /> (l'/ <br /> � � ��l`x <br />