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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 4 �-I�"0 6 <br /> 425-257-8810 - FAX 425-257-8857-www.evereltwa.org �� 6�y,��„q <br /> _ � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> � 0�� Ih'lW1t� �Ji. <br /> PROJECT ADDRESS <br /> `+���� `�EM/,1 �� <br /> Owner Mall Address City S��P P� <br /> l�i�� �"'/.1�.J�11 Rn� I�tf S I�1`Jl41..�� <br /> Tenant Man nddress Gb SlaldZlp P�"° <br /> ,�Il.�..MLTrJ <br /> l�i'i n� Et,t UTM�. 1(��O'�l SM�«� � 1��,�p '�n�D 2�1i ,,,,� �,Sti,,� �l.a �S"1 �'nl <br /> EleCtrical Contractot Mall Address GN SmtdZiP ��° <br /> �,�.� c1n. C-ti. �I(.� N{ �1 uuo <br /> State License Number Contrad Price of Work <br /> ,f'� .a�rl v �t �;1 NT <br /> Proposed Use o(Building Contad Person (Plan Review) <br /> Descriplion of Work lo Be Done: <br /> �l� .k o o (•� SP�-U: ��- vu �ua� n�N� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I hereby certily thaf I have read and examined this applicalion and know the same fo be frue and <br /> correcf. All provisions of laws and ordinances goveming this type of work will be complefed <br /> whefher specified herein or nof. The granting of a permrt dces notp resume fo give euthority fo <br /> violafe or cancel fhe Provisions o/any other state orlocal law regulating construcUon a the <br /> perform�ce o/construction. That 1 am aufhorized,by the owner o/this property to peAorm fhe <br /> work/or which application is made and 1 compty wrth the State Confrecfors Law 18.27 RC W and <br /> 296.200 WAC. �.� <br /> � <br /> .. � � .;.��"..,.� �\ � �����0 <br /> "''�� Date <br /> Sipnature <br /> EO'C¢o�1' -fU9 <br />