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12/29/2008 NON lA:SY PA% <br />�� <br />n <br />ELECTRICAL PERMIT APPLICATION <br />�ooziooz <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 I�% `�y`O 8 <br />425-257-8810 - FAX 425-257-8857 — www.everetlwa.org /' � gl Z�/ � 3 <br />C: <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />��%�C%(; �-�fi1'/li'tir�Yi I�ic�(. , f�.i'.s'i;. �� <br />PROJECT ADDRESS <br />, . <br />�1�KYj��1`I(:.�r T 7fe'��ica'.S �l[`�(�� li(.ii��(':ii�i ) ,�[�( l'.1���;"�J1�'� �lGt., <br />Owner Mall Address Clty StalelZip Phane <br />� <br />T- t-� 1-��: 1��, .l, l; 7�,o E/,,,� �c.y,�-1 � i<��,� 4�.1<<;..;.,.. <� <br />Tenant � MallAdtlress Cily StalelZip Phone <br />��iY'�i�'iG-r'i l�U N�i,;X �j�i�;;:{(./ .)P%��`�i�° ---�:� �r.'? J/.Yi .�n.1�:il.i�/� <br />EleclricalContraclor MallAddress Ciry Stale2ip Phone <br />C'_Or'Nl'�,� �f' D �;'k �_�� <br />State License Num6er <br />c� Jl , r'n `�.,��� �� c _��: <br />Prop � tl Use of Buil ing <br />Description o( Work to Be Done: <br />NOTE: WIRING IN NON•DWELLINGS IS R[QUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3106 <br />� •�'� i J:�'� J <br />Conlract Price ol Work <br />-�3�,.,.� r; �, � �� � �,�_, ,- - <br />Contact Pereon (Plan Review) <br />�� <br />FEE <br />Co��2 -►23 <br />