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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —�✓ w uJ -e i�trG�F wrt •(J ✓ <br />ek.�.� I: idv.�e+-ieQs aC• �vt.���-F wa.qo✓ `y� <br />�.J <br />7 � 3 P�� <br />PROJECT ADDRESS <br />�f'i� .. <br />Owner <br />Gr�:�N�v��w �i <br />Tenant <br />�o ��x � 5�i� <br />Mall Address I <br />'�s. <br />Mall Addmss � <br />I�Duu�ti �6cZ'r(�iG Po 60 <br />Elecirical Contrador <br />Ei <br />Mail Address <br />Evc-�t,c'r(' <br />ciry <br />City <br />LG P-c��oN <br />City <br />nuyusea �se or nucaing <br />Square Footage (If residential new construc;ion, remodel or add(tion) <br />i <br />�-- i <br />Number of devices (If low vollage) i <br />I <br />Description of Work to Be Done: �ShuT1L� (����,y <br />S <br />Gi fo—�73 <br />/o —/z --� Y <br />L�� %�20( <br />StaleJZip <br />SWtefLlp <br />Wa. `1°�OQ�3 <br />SlafrlLip <br />Phonc <br />Phone <br />82Z•2o�2 <br />Phone <br />����y <br />City of [verett Buslness Llcense Number (reGulred) <br />.�� !i�'JD,�j <br />Contraa Prtce ot Work <br />T1'G-usa-ci�J rSo--nw�4wR.� N�,U�u,c <br />Contact Person/Contact Number/Email <br />SAVIN� <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 j} �� C1(� <br />' �F� / <br />/ hereby certily fhaf / have re�d and examined fhls applicat/on and know lhe same (o be frue and <br />correct. All provisions o!laws and ord/nances goveminq t;�is type o/ worlt �vi/l be completed <br />�vhethe�speclfied herein ornot. The granting o/a permif does nof piesume fo give authonty to PERMIf# <br />violate orcancel the piovlslons of any other sfale o�local law regulafing consfruction or fhe <br />peAoimance o(conslruction. That ! am aufhorfred by the o�vner of thls propeRy fo peAortn fhe E I� I O��%, <br />work (or whlch applicatlon Is made and I comply wilh 1he Sfate Conliactors Law 18.27 RCW and � <br />296.200 WAC. � <br />RFt75E0 C&06?011 <br />I o�l�nli <br />�a�� <br />� c- 'To i L` l-t/� <br />� <br />