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�Y-10'2008 1i:75 PAS 425315ih10 1':1R\F.1.1. Ii1.IlC7'ItIC m002/002 <br /> ELECTRICAL PERMIT AF�PLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEnAR STREET, EVERETT, WA 98201 <br /> 425-257-88 i 0 - FAX 425•257-8857 —www.everettwa.org <br /> APPIICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> _ It�ay Pa�NEF�Q w�r � u <br /> PROJECT ADDRESS <br /> �IRvC IUb�SJ�� l31 'L E Lql�s�O�� 1�2. �(C Sk�s ��F 98�58 �6 Y.�� r }i3 <br /> Owner Mall�ddress City State2ip Phone <br /> Tenant Mall Address Ciry Sfate2lp Plqna <br /> 1�cu�1,� F�c�,fr�� vocs say 2_ uc. S�s � . 9A�-8 y2s' 33r��oa <br /> ElecLical Contractor ldall Addre6.a Cily Stata/Zlp Phone <br /> _1�Y�17,/J�.�S 9l8 MCr 5�7 Ba�°a <br /> Stala Licenso Number Contract Prico o(Work <br /> Sf�N <br /> Proposod Use of Building Contact Person (Plan Review) <br /> Uoscription of Work l0 13o Done: _ W��'e �w �D� .S� rr s�� <br /> NO7E: WIRIfJG IN NOIJ-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CADLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby corlily thaf I hevo read and examined this epplfcefion and knmv fhe same fo be true and <br /> corrocL A!1 provisions ol Inws and ordinances goveming th/s type o(work will ba completed _ n � <br /> whether specl(led herein ,not. Tho gran(ing ol a pormit does not rcrsume to givo authonty to /� �� � <br /> violnto or cancol(he pr i ons o ony othor stafe orlocal law repuPahng constructlon or the I� <br /> peAormance o!cans� cti n. 17 3f I am euthonzed hy fhe owne�of fhis property to poAom�tho i f �� <br /> work lor which appllc lion is m o and t compiy wdh tho Stafo Conlractors Law 98.27 RCW and Q <br /> 296.200 WAC. /J <br /> �/- <br /> /1�J0�-Ot <br /> SiQnalur Date <br />