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FP.OM :Evergreen Stdte Hedt $,�.9/��� FRX N0. :4252596660 . - �� Wov. 20 20E9 06:4GPM P1 <br /> � � � <br /> ELECTRICAL PERMIT APPLICATION <br /> C1TY OF EVERETT PERMIT 3ERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 88201 <br /> 425-257-6810 - FAX 425-257-8857-www,everettwa.org <br /> APPLICATIONB ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ..2.2C�.t" 5' � ST. <br /> PROJ�CT ADDRE88 <br /> ��c s7�w.s��PT ��ss s�"s: ,�v 9'B'�/ �s� o39Y <br /> Ownar Mall Mdreus CHy ute;e2lp PhOne <br /> TeOant �dail�lddrese Clly S�alo2lp Phono <br /> ��� s- .s��� �� zizv R�r� .a� � �'�.� ,z.��. �i/Y <br /> Elootdcal Cnntrector Mail Atldroee Clry t;leterl.lp Phona <br /> �'Y�L�Z� �f',2�/r Jt/ � � <br /> Stata Licenoe Number Contract Price o(Work <br /> �SiG��r Tlr,j�. _��rr � <br /> ProposnJ Use ot Buildinp Contecl Pereon (Plan Revlew) <br /> Doscription of Work to 8e Done: /�/ Gl�,i<CGs/r 77> �R;Il1y/O a <br /> _,�I� %L'YC c�l2 /S✓7�t/G eti.e!„�e�i s i� �z'i.P.,�.�!'.� <br /> NOTE: WIRING IN NOIJ-DWELLINGS IS REQUIREDTO FEE �� <br /> BE IN RACHWAYS, MC OR AC CAAI.[. <br /> CITY OF EVERET7 LOCA�SALES TAX CO�E IS J106 <br /> I here6y cortify thac l havo read end axemined this appqcatlon and know the seme to be 6ue and <br /> cormct. All provlslons o!laws and o�dfnnnces goveminp fhls type ol�ti ork will be cnmplefed <br /> whefher specihvd hnroln or not Tho grant/np ol o pormd doos not rnsuma ta glw a�thodty to <br /> violate ar cnnr.�l fho�rovisions of any other slote or locallaw iepuPnt�ng construction orthe � ��' <br /> perlormance o/cons rucfia�. That 1 orn euthorlaed Ay fhe owner ol fh/s propa�ty to peAp rm tlra n//_ <br /> work lor whfch oppllcafion Is mede and!compty with fhy Sfafe Gonhacfors Lew 18.27 RCW end �� l`� <br /> 29G.200 WAC. <br /> �. ��/�/� <br /> slpnaNrn — Uete . � � <br />