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08/26/200B 11:54 4254917766 OP.CA ELECTRICAL CONO PAGE 02/02 <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - wwrw.everettwa.org (-'-0 <br />APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br />05/"1 (<t 01 hue, L Jr)- ci &% <br />PROJECT ADDRESS <br />I �y pT p <br />Ownerfn flan Address C y State/Zip pncne <br />! <br />Tonant Mall Addm s City State/Zip Phone <br />Gres y�l�I ,�z� l Cry �F� s Po Box w6ci 3 al %t I Cr k, wirt c,� <br />Electrical Contractor MailAddress City State/Zip _ Phone <br />yts 4�J � <br />0 af r4 f�'G G1 �1 �I IV /I- , GAO <br />State License Number Contract Price of Work <br />6� �� <br />Proposed Use of Building Conta1 Person (Plan Review) <br />DescdptienofWorktoBeDone. _flSe,-)De.,rle,�rl �� �� ��'r7�Gt l25I-2--l�) <br />r <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby certify that I have read and oramined this application and know the Sarno to 0 true and //�� <br />Correct All provisions of lows and ordinances governing this typo of work will be completed w <br />whether spocifiod heroin ornot. The granting of permit does not pprosumo to give auffrority to <br />violate or cancel the provisiongf any othor state or local lacy regu/sGng construction or the <br />performance of construction. hat I am authorized by the ownerof this property to perform the <br />work for which application is made and I comply with the State Contractors Law 10.27 RCW and <br />258.200 WAG. <br />� r 1-1 <br />Signature Date <br />