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ELECTRICAL PERMIT APPLICATION <br />C! � Y OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />! 4G 7 �l�v�ou� �v. �-vHa� rT �,rd-- <br />PROJECT ADDRESS <br />�� --���'y <br />C—I � � z �d��f <br />J�sl�uA- �t�2v�7��. �y 6 T�r�-v� N,�-- ,2v ���� w�-9��3 <br />Owner Mall Address Ci;y State/Zip Phone <br />Tenant MailAtldress City State/Lp Phone <br />�LJ�CJTI�/Z. �2�J <br />Po�Nzg-�e����,rNc. �38�r�` �ac-� C�'t,✓ W� 1�Z3� <br />Eleclrical Cont�ac�o� Mail Address City State/Zip Phone <br />� 1 l� T'� � 1 �t'o�� <br />Stale License Number (required) <br />Proposed Use of Building <br />Square Footage (If residential new consiruction, remodel ot addition) <br />Number of devices (II Iow voltage) <br />�53 � 8 0 <br />Cily o( Evereti Business License Number (required) <br />� 2 5� <br />Conlract Price of Work <br />�6'�vl� d'�i�V `7�',� 36�-T,,F"7-(3 <br />Contact Person/Contact NumbedEmail <br />�'�tLGL �J Z� <br />Descriplion of Work to Be Done: �� s��L� S� �— P���L `/�% S li0 �, <br />___� r�� �-t� <br />w� Q-t� ►�A-1� 7 0� Svro p. � N sT.f�u -r�2� �� c-�r T�h s w• <br />f�-s NP �� o� IJ r� c�c r�� z�-r � s t�l��'L€�i . <br />CITY OF EVERETT LOCAL SALES TAX COOE IS 3105 <br />I hereby cerlily fhat 1 have read and examined fhis applica(ion and know (he same to be Lue a,d <br />correct. All provisions o/laws and ordinances goveming (his type ol worlr will be completed <br />whe(herspeci(ed herein ornoL The g�anting o/a permif does nol presume fo give aufhonfy fo <br />violate or cancel the provisions ol any o(her state or local law regu/ating consWction or the <br />pedormance ol construction. Tbat 1 am aufhonzed by fne owner ol this prope�fy to �eAomi (he <br />�vortc Ior which application is made and I comply wilh (he Stafe Con(raclors Law 78.27 RCW and <br />296.200 WAC. �, <br />Fr.V15`D 089G?�W <br />FEE <br />7S °� <br />PERMCI'# <br />�1�1�-C�7 <br />