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SEP-21-2009 23:53 From: To:2578857 Paee:1�1 <br />ELECTRICAL PERMIT APPLICATION <br />,. CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 q <br />425-257-8810 - FAX 425-257-8857 —www.everettwa.org <br />CoSog �0�6 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SAP MW 1� #% <br />PROJECT ADDRESS <br />owner L Mall Address City State/Zip Phone <br />T(een3nt Mall Atloress/� 1 (� City State/zip ]� Phone <br />r \/lr'1 �n I ✓rn r�r `1 7i � l -n A ,l.ai..., �... %�i llvn.� 1 r IA is r, ^tnl (� �: �•�•. 'l i r r <br />Electrical Contractor Mail Address <br />rSomrrP ,qqD7 <br />Stale License Number <br />Ls <br />PropotfeV Use of Building <br />Description of Work 10 Be Done: <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />City state/Ilp Phone <br />R <br />$z,�a� <br />Contract Price of Work <br />AIm a� <br />tact Person (plan Review) <br />y certify that I have read and examined this application and know the same to be true and <br />. All provisions of laws and ordinances governing this type of work will be completed <br />it specified herein or not. The 17ranting of a permit does not resume to Vivo authority to <br />or cancel the rovisions of any other state or local law regulating construction or the <br />Lance of construction. That I a,n authorized by the owner of this properly to perform the <br />r which application is made and l comply with the State Contractors Law 18.27 RCW and <br />n WAr <br />�l c� t42zs '7 --a5q.� <br />FEE <br />qdq-9� <br />