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10i12i2011 1J:08 F,LT �2555989Jd Ever6reen Secur3tS �002 <br /> � � <br /> ELECTRICAL PERMIT AP�'LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200CEDARS7REET, EVERETT, WA98201 /(��-/Z.�1/ <br /> 425-257-8810 - �AX425-257-8857—vvw��.everetlwa.org �l//0�6� <br /> APPLICATIONS AR@ ACCEPTED FROM 8 AM TO 4 PM <br /> a8'�o� t NQ,-�m a-e. ►� Stiu�FC �� 1 <br /> PROJECT ADDRESS <br /> py„�Q� Mall Addnss Ciry St�Mlp �� Phone <br /> Si�xrA N�ed.ia �Wt�l�nn�re� 4u�,1e�� Eve�e+l� r�q g� ��� -�''�� <br /> Tenent MallAtldress Ciry 101 3tate2p �����8 <br /> � �_ .i,ra{�, g115 � �=� w�'+a8zla3 ,�s� <br /> E�earical ntraaor Me adrw sa�e2�a Fnone <br /> i- v��sz� ia�.� a,a�� <br /> Stete Licence Numlxr Conhad Price o(Work <br /> o�nM����� — m <br /> Pmposed Use of Building CoMeG Wrson (Plen Roview) <br /> DesaipUon of WoAc to Be Done: l�i�'�" " � ' ��`--+ ��Y�' ' "�- <br /> � v <br /> NOTE: WIRING IN NOf�DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CRY OF EVERE7T LOCAL SALES TAX CODE IS 3706 �1 t 1 �-O�� <br /> I heieby certily that I have read and axpmined Mia apqlica(ron end kmw ffro same fo be We and � <br /> cortrct. All pmvisions oflaws and o�drnanas poreminp Ihis type o/wvric w;ll bs,compkfed <br /> whethsrspeciBed heiein prnot. The 9rondn�ola permd does rrof presume ro piw sutnairy to <br /> violafe or cancel thenro visions olany nther late or local law repuratlny conshvction or fM <br /> perloRnance of ctinsiru.ehon. That�am authonsetl by the owner o/this property top0�/prm fh� <br /> wark Ivr which applicahon is metle and I romply wiN the Sfate Confrectors Law 79.27 RCW and <br /> 296.200 WAC. <br /> ��k �� (� � � <br /> Synature oate <br />