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10/10/2014 02:52 360-B25-1994 PAGE 01/01 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www everettwa org <br />PLEA 5 E GA > L- ? b - `t 0 (v 6.2- ( Y lro R f ll -t ry'le kr-r <br />1Rt� �1r�Ov]p(l O'VE r CVtr''-- r- �`��/ <br />PROJECT ADDRESS V C/ (//Q <br />NTnafd ELlur\A 1141 5`4 QLw- w jeA34-t2 _ JL-)A 1U 1 <br />Owner Mad Address City State/Zip Phone <br />Tenant <br />Mall Adders <br />City — <br />sWetZip <br />Phone <br />{IEuu Ekes h�cc l Cow}rt�esw 2_Snoi_�E 3S�}'' S� Ei��r.cAg , t-A 98ti7Z <br />EleHncal Contractor Mau Addietis Cuy State/Zip Phone <br />44EccocCq-1NA <br />Slate License Number (required) <br />Proposed Use of Building <br />o-7 S 5 •,,• -4+ <br />Square Footage (If residential new construction, remodel or addition) <br />Number of devices (It luw voltage) <br />_ O53sAq <br />City of Everett Business License Number (required) <br />"�8000, U0 <br />Contract Price of Work <br />Contact Person/Coninct Number/Fmnil <br />it I.G.- G o � y ✓itnV . LUWt <br />Oesctiplion of Work to Be Dune- _ 010A (Fr r - _eAe5- CA-� �a n-e,i mc144— aAjj <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby cortflY !gall have toad and examltiod thls appllealron end know Ule satire to be Uua and <br />coroct All provisions of lows and ordinances governing this type of worlt will be completed <br />whether specified herein or not. The granting of a pomrit door not presume to give authority fo <br />violate or cancel the provisions of any other Unto or local law mgulatin eon-dtuction or the <br />performance of construction. That/ am authorized by the owner of this properly to perform the <br />work for viNch application is made and I comply with the State Contractors Law 16. 27 RCW and <br />296 200 WAC. <br />FFF <br />80 <br />PERMIT# <br />Ejy10- �g <br />FEVi,VD04e620r4 <br />