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�3/25/2��8 12: 15 4'L53778377 EOSCH ELECTP.IC IIJC PAGE �2/�2 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, �V�FlETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8ti57—www.everettwa.org <br /> APPLICATIONS ARE ACGEPTED FROM e AM TO 4 PM <br /> 1 I I L<o }�a i n e� �i c(d W�u-I #� N � — <br /> PROJ[CT ADDRESS <br /> Wal+ K�uYsvik. 131 � e l�.lusl�cr� �r Lalr..c Sf�cve�,.s,ulPr �b'ZSg �,o�: yc�/z�3 <br /> Ownef <br /> Mall Addrnas Glry Sta�nrGn �0^e <br /> Tenant Me��M9G <br /> Ly�, Stala�Zlp Pha�e <br /> gLti�� E(ocf�icZv�� POr3cxlU83 I�ttuS�'evi.��s, v�A q$Ls� YrS.3�78�6 � <br /> Electri�l ConlraGor <br /> Mail Address G�ty steldZip Piwne <br /> �f�'j��-}�1 ��'3 Q r Contrad Price or work <br /> Statc Licensw IdumUor <br /> Pro{wstd�Usc ot Buiminy Contad Person (Ptan Revlew) <br /> Desc�ption of Wak to[ie Done: W I(C F1 G1n� ��Ou SG d`��0 S F <br /> NOl'[: WIRING IN N�N-IJWEI.LINGS IS RL=QUIRED TO �� <br /> CiE W RP.G[WAYS, MC OR AC CABLE. /,1 O D�' <br /> ��� <br /> CITV OF EVERETT LOCAL 5A1E3 TAX GODE IS J70S <br /> �a rrocfY AAp nNslons ollnws anJ or�rJXi�l iiices�vcmPug I�is�o o!work will be rom�leted 2� �V u�j�- �S 3 <br /> w6ether spr+cified hertain or not Tho grenling o`e�u3m�rt does not presume to alve auihonty 1u <br /> vldOfo o�ramcel Wo provislons o!any otl�or ateM orloca!law rogul9ting cansht�cUon or tha <br /> rerfomvincr o/rnnstnicfion. 77iaf 1 am nulhorized by fhe owner ol fhis property ro peAorm the <br /> wak!or which appLcatbn is madc and I comply with fhe Sfafe Caifractas LeW 78.27 RCW�nd <br /> 2�e.zon wnc. <br /> / '�' �� ���"`��G'v <br /> c�gna�ore � — uare <br /> / <br />