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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — v,vvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />3g33 <br />PROJECT ADDRESS <br />'C%d'<2L 311`33 1?ohpmi5� Jam- 611ifr1f Will 47,5231'� <br />a <br />Owner <br />7 Nlall Address City State/Zip Phone <br />Tenant Mall Addre Ss City State/Zip Phone <br />Mall A"dross City Stele2lp Phane <br />N UrfFco�ICS <br />State License Number <br />Proposed Use of dUllding <br />Square Footage (If resldenlial new construction, remodel or addition) <br />Description of Work to Be Dona: <br />Contract Price of Work <br />- 'Q <br />Contact Person (Plan •Review) <br />NOTE: WIRING CI 111REG TO <br />N RAC WAYS MC OR ACCABLE. <br />CITY OF EVERFTT LOCAL SALES TAX CODE IS 3105 <br />I he eby certify that I have read and examined this application and know the same to be true and <br />correct. All provisions of laws and ordmancos governing this type of work will he completed <br />whetherspccified hetarn or not. The granting ofa pemrd does not presume to give authority to <br />violate or cancel the provisions of any other state or local law regulating construction or rho <br />performanco ofconstruchon. That I am authorized by the ownerof thispropony to perform the <br />wodr for which application is made and 1 comply with the State Contractors Law 18.27 RCW and <br />296.200 WAC. <br />FEE <br />�D-oU <br />E' 130(--Ir� <br />9EL-d ZOO d 261-1 00E999EO9E+ <br />dVOONV-Kdd IYdP:Z i E102-El-NVr <br />