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Aus . lb' . i006 4 � '-.2A1�1 IECHWA SYSTE�!S INC No • iE60 P • I <br /> . , � � <br /> ELECTRICAL PERMIT APPLICATION <br /> , CITY OF EVERETT PERM�IT SERVICES � <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PI+11 <br /> � 15 ;,�,;�; ; , �,y� <br /> ���I � �_�'� � . <br /> PROJECT ADDRESS <br /> , ��M.� 1�,���n��n�- � i c� .� �0�5 .�, ��a � <br /> OwqBr M1"all Address ' Clry Stata2lp Phone <br /> Tenent Mall P.dtlroac � Clry . . State2ip • Phona <br /> �.�j �.�v�er� I�� �l-��e_�� � � �1sV I fi,���'� <br /> leCtrlcal Contractor Mall AdCreas Clry StaterLip Phore <br /> ���.�N 5����f lu� . �do.� . <br /> Stale License Number Contratt Price o(W rk <br /> Proposed Use o�lding Contect Parson (Plan Reviaw) <br /> Oescrlptlon of Work t, Be Done; � � �� � 1 ` <br /> NOT�: WIRING IN NON-DWELLINGS IS REDUIRHD TO FEE <br /> BE IN RACEWAYS, MC OR AC CAeLE. <br /> . � , � <br /> CITY OF EVERE77 LOCAL SALES TAX CODE IS 3105 . <br /> 1 heraby cerflfy that 1 heve read and exem/ned this application 2nd kncw the seme to be true end <br /> correct. All provlslons ollews end ortl/nanceS goveming fhis type o/work wlll be comp/eted <br /> whethar speci0ed hereln or not 7he grenUng of e permit tloes not p�asume to plve authoNry to <br /> v1olefe or eoncal the provisions of anv other stete or Ince/lew reguleting const�uction or the <br /> per�ormsnee cf c structicn. That 1 am authorizetl by the ownerot fhis roperiy to perform the <br /> viork for which liceGon!s made and 1 compty wlth t:!e Stete Contrac�rs Laei 18.27 RCW end <br /> 298.200 WAC. ����- �� <br /> S:gnature . De;e . <br /> ' ' I - ' <br /> � <br /> 2 ✓ C�� - - 5 , -� � <br />