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( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMfT SERVICES <br /> 32G0 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-885�—www everettwa.org �` /,. �� <br /> / <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �/iO9�-OO� <br /> 1 LJ /r�1 ��� Pt.L`� �� �Vc1Z�"f� �.G11,_ 7�O'�C�� <br /> PROJECT ADDRESS <br /> (^)�S>rl?C 1.� <br /> Owne� M.ail Atldrass City 5[atelZio F'hone <br /> ��/l1 c�{�c ���l'�''�t- � �� �o C CC. _ <br /> Tenant Mall M1Jiwo Oilr �������? r�'O^O <br /> Grn�C .�6�(7 l.1� ��'' C�- �.��IJC;CU�ett l�\�•gs�_,?i�'�,i e-�3' $,� <br /> Eledncal Contractor Naii�ddress City State2�p Phona <br /> � w <br /> ���r1c' �'s`'r'�/�T� 7�� <br />� 9lele Liwuan fJwuLv;i Conlroct f•ricc ol Work <br /> '�,�s_� ��=��3-i�OFs� <br /> Propcsed Use of Building Conlact Person (Plan Review� <br /> ` r' k�;�3-tce ���S�__ <br /> �escription of Work to Be ��ne: ��'� %c � �� v�'4' `�l'��Z � ��� <br /> NOTE: INIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> I 9E IN RACEWAYS, MC OR AC CABLE. � <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certdy tha!!havs read ar,C e.ramined;his application ar,�know tne same to be m:e and <br /> conect. All provisions ctlaws and crdinances,roveming this type of��or'�c a�if!5e ccmpletsd <br /> whefher sper.ifiedlierein o(nct. rhe 5rentinq o`a permif does nof pr=sume�o give aulho,rty to <br /> v:clate or canr.ei the provisions o'any o!h�r state or local law r�gulatiny construction or�ho <br /> OCfIOfIHdnGB OI CORStrucfior,. 7ha;I am aufhonzed by iRe owner of this property fo peAorm lhe <br /> 'v�crk/o�which appfication is rnade and 1 como7y wifh ihe Stale Contracfors Law �8.27 RCW and �` <br /> 296.200 WAC. '// G�� .' (�� J <br /> h �� <br /> C- <br /> 7 �' � p��l - I <br /> Signawre <br /> I_��1.��1L—\,�-�'� l 1�� � � <br /> Z d L09609L09£ �!�l�el3 ��W3 e£9�OL L l l0 deS <br />