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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+w•evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM T�4 PM <br /> o ME�e2►t..c_ x Pkw► . <br /> PROJECT ADDRESS <br /> Owncr MA�Address Cl�y StatelZlp Phona <br /> C�f�S) <br /> 7�E.0 /kIRCl��4FT - 30D$ !(Y377f c5'J' 5��,�� LUR �/�� 35����v <br /> Tenant MallAddrees City Stala2lp Phone <br /> (ya.$) <br /> �Mo�U4 l'�/� CD — I53�3 NE 9csM Si., �'��vloND, I,u,4 98dS•Z t�o�.-qsY�f <br /> Heetr;ceFCoMractcr MBiI Atldres, Gry SWteZp Phonc <br /> REDn�occ99�e4 $�,r�as <br /> 3tate License Number Contract Price of Work <br /> . / �7U2/l(SO�I� <br /> , �� <br /> Proposed Use of Building . Contacl Person (Plan Review)��_ <br /> �escriptlonofworktoBeDone: �A�S7R�(����� ��C ✓�������SPEjq.'�,�, <br /> LJNCS FDR T�l�tR�IT MOV��Ub 7a N�h/ LOc�4-77aV. , � , � . , <br /> _ � <br /> �° � I <br /> NOTE: WIRING IN NON•DINELLINGS IS REQUIRED TO FEE <br /> 8E IN RACEWAYS, MC OR AC CABLE. <br /> � ��00 <br /> C�TY OF EVERE-TT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby ceRrfy that I lreve resd and examined Ih/s application and know tho sama ro be frue and <br /> corrtecf. All p!ovisinns of laws and ordlnances govorning th/a fype of work�vill be,comploted <br /> v{hefhor spec�frod herein ornof. 77ie grsntlnp�l a parmd does ncf Wesume to��ve authonty to <br /> v�olnte orcaneel fhe provi,sions o(any afher stote orlocal law reguleting construction or fhe <br /> perlonnance ot constn�chon. Thaf 1 am authorized by fho owner of this property co perlorm the <br /> 296 200�WAC applieatfon is made�nd 1 crompty wlfh fhe Sfate Contractors Law 18.27 RCW and <br /> � <br /> -D�ir.a.mJ 9/a`l-�� <br /> SignAlum Oata <br />