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r <br /> � . <br /> ELECTRIGAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICFS <br /> � 3200 CEDAR STREET, EVEREl-i', WA 98201 �D�7Z,a � <br /> 425-257-8810 - FAX 425-257-8857 -www.ever2thva.org <br /> C�3/b-f83 <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> [S% lD L' (_/ ! / � v"v' �r�/ !r c P K �G� !r'/( GCJGI y SGL� / � (!�-Q� <br /> PROJECT ADDRESS � <br /> i 9�'s ��'� �¢ � � /��tJ <br /> s�e_al���t � LUf o`� C LLC Shc��e / 'h v �a 9�/bp <br /> Owner Mall Address Cit <br /> ,�/ r Y State2ip Phono <br /> / ( -e✓`r / /r �I.Y cr� ��W `� �'7�7� Z <br /> 7����« � � � e � � <br /> ,��� �� � �.��� y1s- �su - <br /> Tenant Mall Addmss City Stale2lp Phone <br /> _�_� �( / + / �U o"Z o'l 3 � � cq�� L<J. /f L S <br /> //il r 'P l'G 4��C ul cPQC� <br /> E'octncal Co�draelor Mail Address Ci State2ip Phone ` <br /> :SlN�1 _F� T910 � 3 ���(� `� <br /> Stale Llcense Number Contract rice of Work <br /> i'� � / �.� �� ��z�_ �'��.� �UG - 730 -�s�d <br /> Propose e of Building Conlacl Person (Plan Raview) <br /> � � �' � 7` ��P <br /> �escriptian ot Wark to Be Donc: ��1� d�1 �Q l� ,� L i N C �_� <br /> .�—� / / /J c <br /> +`t P C �C O /ti C� f G✓ % ��i , r,t O'�!� I D ✓ �l (/ <br /> � 7 <br /> NOTE: WIRING IN NON-DWELLINGS IS REOUIRED TO FEE <br /> BE IN R4CEWAYS, MC OR AC CABLE. � r O <br /> � <br /> � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 herobycortily fhat 1 have rood end examinod fhis applfcalion and know fho same lo bo Irue and E I 3 I ��. I g� <br /> correct. AIf provislons ollaws and ortiinances goveming fhis fype ol�vork will be complofod <br /> wltether speafied herein or no(. Tho granting o(a pormif does not prosumo fo givo aufhonty fo <br /> viola(o or cance/the provisions olony olhor sfa(e or localla�v reguleting consfrucfion or fhe <br /> perfomience ol consfrucfion. That 1 am authonzed by the owner oI lhis property to perform tho <br /> work forwhich application is made and 1 comply with tho Stafe Confrac(ors Law 18.27 RCW artd <br /> 296.Z00 WAC. <br /> l.� �� <br /> ? .��/� �C� <br /> SlgnaWre� Datu <br /> /3 a �-3 <br />