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JUL-�2-clll� 13:51 From: To:2578857 Panr. cl�l <br /> . ELECTRICAL PERMIT APPLICATION <br /> .. eITY OF EVERETT PERMIT SERVICES -� _3_13 <br /> .:.�� 3200 CEDAR STRE[T, EVERETT,WA 98201 <br /> 425-257•8810 - FAX 425-257-8857 -www.everettwa.org C/3 0�7 --��� <br /> APPLICA710NS /lRE ACCEPTE� FROM 8 AM TO d PM <br /> _�:._. <br /> %��� l, • C�1°��� "� � <br /> __�_� �� <br /> �� !C_ �lu fe � <br /> PROJECT ADDRESS '� <br /> Stale/X�p '`,2� •Pnoae <br /> Owner � Maii Atldress - v� �'�y `'T <br /> � �nsor ���A-�r� s -- �vo <br /> Tenan Mall Atlaress C��y <br /> Sid�e2iF Phone <br /> �o�i►-I1-o� � �i� o�a� 1 '(Cc��►' ,`r� IPC�P�- V�I� cl�?vl `��� <br /> [IeCl�ical Contr9CtOr Mail Address ���Y � <br /> Sldle2ip Phone <br /> S��� � � ������ Conlracl Pri��ork <br /> Stala License Number � ��?�� n� <br /> `X n �Il <br /> Propose se of 6uilding Conlact P�RevioW) <br /> Description ol Work to BC Do�e: ��O_— I���!""-'��� . <br /> Covt`1-r'� l ;c;e�s� <br /> I tJOTE: W IRING IN NON-DW ELLINGS IS RFOUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. <br /> 50�oa <br /> CITY OF EVEP,ETT LOCAL SALES 7AX CODE IS 9105 � I�O � � � � <br /> � i hereGy certify 7hat/have�eud an�' �xamined fhis apFGculion and know fhe samo fo De We ond <br /> cerroct. All provisions ollaws�nd ordinancos 9o�eming ihis fype o�Work will be compleled <br /> wholhe�specified hereln or noL Tha qranfing of a permd does not presume fo givo authonty to <br /> v�ofafu or cancel fhe provis�ons ol any other state or b�cal mw regu�Dling COnSf/Ucfion Or lho <br /> per'ormance of conshuction. Th�f 1 om uulhorizod by Iho owner ol Ihis property to peAorm t�e <br /> �rark 1or wnrch applicailon is made ond �comply wifh Ihe Ste1e ConUacfors Law 18.27 RC W nnd <br /> 256.2 WAC. �� , <br /> ignaWrc � ' f]alc �� <br /> ��Q Cc�.2 4 . r-�2.S' `��1 ) a75�-I� ���� ��- <br /> I .._.___--,.._v.._.._ � <br /> _.._._._.--------._..._.__�_ <br /> ._.___ . <br />