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14/11 2011 10:0& F,1S 25J5618J14 OFFICE <br />Ig�UUl <br />EL�CTRICAL PERMlT �1PPLICA.TIOM <br />CI'�Y OF EVERETT PERMIT aERVICES <br />3200 CEDAR STREET, EVEREIT, VJA 98201 <br />425-257-88', 0- FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCFPTED FROM e AM TO � PM <br />37ii r�o�f p r�,� <br />PROJECT ADDRESS <br />ownar <br />Tenant <br />Mall Addrecs <br />Mell Addreas <br />/� <br />Clry <br />Ciry <br />li—/�(�--1/ <br />�llll �U�D <br />StetelZlp <br />Stats2lp <br />���y <br />Phone <br />P�one <br />�uL�Sr�° .Tc.n _ G //S/r g3=�AjIL� S G.� �AKEWoe� 66��4 9�A 2,t'3�12'8�/� <br />Elettfical Con redOf iNoll Addraes City Stata2lp Phone <br />fa��SS� °I 2 � <br />Stete L;canan Num6er <br />GCes��c�r�;�� ���'sIa{;.�s� <br />Pfoposed Jse of Building <br />Dascrlpiion of Work to Be Dbna: <br />_� �2 6ES'a0 <br />Contrect Price of Work <br />l� hC'� j�ri��.�A�Y <br />Contact Pereon (Plan Raview) <br />_.11 ' '� Gy. ' �:=��_�, ,:f'�,,C� T <br />NC)TE: WIRING IN NOW-DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCNL SALES TAX CODE 19 3106 <br />I hore6y cerflry that I hdva reed ano axeminod fhis epplicetlon and know the sema to 6e :+ue and <br />corro��, All provlsions o/lewa and ordinences goveminglhia typa o/ work will be comple(ed <br />whafherspecl9od harein ornot. The grantlrrp o/ e peim�t does not presum6 to ylve eufhority �o <br />vlolefu or cancol the provisions o/any other sfafe or fuCal /aw regWefing conshuction ortho <br />performance olconstrocfion. Thet I am au:, ��nrod bylhe owner of thia property fo perform the <br />work lor which application ls made and l comply with the State Conhaclors Law 18.2; RCW end <br />296.200 WAC. <br />LI������� <br />L <br />