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( <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 — www.everettwa.org <br />APPLICATIO�IS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br />9►� io�� �� s�� r_��e�zr� wA "182�8 <br />PROJECT ADDRESS <br />SrEdc f��r-rr2 qi� �o�i�� ����,= ��«er_ w�l.9g�og <br />Owner Mall Addreee City SlateZp Phone <br />� � ) -�(� /-��O <br />Tenant Mell Addrose Clry Stete2lp Phone <br />/� <br />� nl �l �i l�i t� �1 <br />. <br />iuc �l.��i� /`ls//-'�/ ���f <br />Meil Add�eee Cly <br />���^"�'I � r 9�' I C J <br />State License Number <br />RPy � ��.+n�..e S Y I� <br />Propased Use of Building <br />yas"-ya�- <br />Stale2lp <br />Contract Prlce oi Work <br />Contact Peraon (Plan Review� <br />7escrlptlon of Work to Be Dane: Cnn., �71� ; �._, 2i- w� rP 1�n �y� <br />_� <br />NOTE: WIRING IN NON-DWELLINGS IS RCOUIRED TO <br />BE IN RACEWAYS, MC OR AC CABLE. <br />CITY OF EVERETT LOCAL SALES 7AX CODE IS �105 <br />I hereSy certi(y Ihaf I heve reed end exemmed thrs applicatlon end know the seme fo be frue end <br />conecf. All prov�sions ollews end ord�nencas goveminq this fype ol work wdl be camplafed <br />whefher speulied herem or nof. Tha granting ol e parmif does nofp resume fo give eufhodty to <br />v�olete ar cencel the provrs�ons ol eny other stete or local lew regu/eting construction ar fhe <br />peAormance o! consfruchon. Thet � am eufhonzed by the owner ol this propeRy to peAorm �he <br />work /or whrch epplication is mede and I comply wrfh fhe Sfete Contracrors Lew 18.2� RCW end <br />296.209-W,iC. <br />;z <br />3/�.' /nti � <br />FEE <br />� osc�-03s <br />Phone <br />