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10/09/2006 05:55 4254885288 PAGE 01/02 <br />Hlrii-1J-1.19 r•1(1 IU:42 Hn EVI `tI-I PhMM1T !ihKV10ES PAX NU. r ''idb-fl-BbW r�l lu:at' S17P, OPN,: <br />ELECTRIC/.L PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 -wwy/.everettwa.org <br />APPI-ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEerr & CREDIT CARDS ARE NOT ACCEPTED <br />326 57- =6-2- <br />PROJECT ADDRESS <br />Owncr n T~ Mall Address City StMe/zlp Phone <br />P Y lair, a `o � -*z eLrak i- Sg201 _ tMtueO ARa�cri2oD _ -� ,65 <br />Tenant Moll Address city St3hizp Phone <br />�tD�u _rry �vtc�s li(3z•� ►� +cg�Wy N *105 q ,� 42� 5;�4r <br />Electrical Contractor Moil Addroso City St2lo21p Phono <br />SEST032ar, 1-2g•0-4 <br />Stale Uconse Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Reviow) <br />Description of Work to So Donn: I t, 01.,Q l sre N b�tiri u u-- <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />EE IN RACEWAYS, MC OR AC CABLE, <br />CITY OF EVERETT LOCAL SALES TA% CODE IS 3WS —� <br />I he,oby ar:niry that 1 have rood and oxnminod this app//Cation and know the same to ho true and <br />corrcG, All provisions of laws and ordinances governing this t po of work will ba completed <br />whoflier specified heroin or not. The gronring of a pemi t dop not�rasume to give authority to <br />vinlato or cancel fho pprovisfons n any otherstala rlocal law regu afinq constluebon or the <br />ponormance,. - consPruct/on. Thni t nm authodzed by iho owner cf this properly to parfarR!nl� the <br />wnn<ror whim appiloation Is maao and I compiv with the State Contractors Law 18.27 RCW and <br />266.W0 WAC. <br />„ignalurc Data I <br />