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F_LECTRICAL PERMIIT AI'PLICA�'ION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.ora <br />1 -�-- e <br />PROJECT ApDRESS <br />y-a4-r5 <br />� � S� � -I6G� <br />���\ .� �.,.. � n�d-� S �- �as• 4�{g • �„��3 <br />Owner Mall �ddress City StatclZip Phone � <br />Tvnant <br />Med Address <br />� <br />ConinctOr Mall AtlEres; <br />� <br />State License Number (requiretl) <br />SFR <br />Proposed Use of Build�ng <br />Square Footage pF res�denbz� new construction, remodel or adtlition) <br />Number qf device, Qf low voltage) <br />Dascriplion o( W ark to 6C Oone: <br />C�TY OP EVERETT LOCAL $ALES TNC COUE IS 3105 <br />C�ty <br />Gty <br />SIa1c17ip <br />$ldle/Zip <br />Phonr <br />Phone <br />oa aa 3 � <br />City of Everett BUsiness Licensc Number (reGuired) <br />�3bo <br />Contract Price of Work <br />�im��- �� . ���i. �Ao� <br />Contact PersonlContact NumbedEmaii <br />I hereby certily 7haf 1 ha�e read and r.xamined fhis applicatlon and know fhe some !o be frue and <br />cor�ec(. A!l provisions o� Ivws and ordlnences goveminr� Ihis lype ol work will be comp/rted <br />whefh,er snealied herein or noL The granfinq o( a permit does nol presumc lo give authorrty lo <br />violato or concel the provisions o1�ny ofhvr stale or/ocallaw regulafiny consW�Oon or fha <br />pe/lormonce ol construcfion. TNaf f am puthoriz�d 6y fhe vwner o(thr5 property to peAomt the <br />work !o� whl�h npplicabon is mado �nd � comply wf;h Ihe Slafe COntroctors Law 18.27 RCW and <br />['�'i.2oo WAC. <br />TI� <br />Rf. v�."iu o1S(%; i t 1 <br />FEE <br />5(�� °°-. <br />P[RMIT� <br />E i �Sb� - I (�o <br />u <br />