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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.evereltwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />7.�.• 'l•S ��� �,.'h ,�L tl;ii Ct� �1"� 1r <br />PROJECT AUDRESS <br />��� 11 d; u" ` �x' �'-1 �i <br />Owner Mall Addros� Cily <br />Tenanl <br />Mall Address <br />City <br />Slale/Zip <br />Slale�Zip <br />Phone <br />Phone <br />I I Clc��� � � . �•� F�.t rl�h' '� r;� �1 ��� i �f y 1c �L ��u, �,1.�- l � � �.1'' <br />%� ' (�'�•� rfSZi( ��yk�/5%r <br />Electrical Coniractor 61ai1 Addiess CII � <br />Y Stale/Zip Phone <br />Il 1 �1 u__vC� r�z v ir �� il � <br />Stalo Licr.ns� Numbcr <br />/4 ` . � �� <br />Proposod Usr, ol Buildiny <br />Descrlption ol Work lo Do Uono: �� r�� �� �'� (�� <br />NOT[ WIRING IN NON-DW[LLINGS IS REQUIRED TO <br />�E IiJ RACEWAYS, MC OR AC CABL[. <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 7105 <br />t� C'!i <br />�L �['`C� <br />Coniracl Price o1 Worh <br />��! L �. � ,. <br />Conlact Pcrson (Plan Revicw) <br />1 homh� rrh!} that I havi� iead nnc7 raarnmed ttus applrccition end know fho same lo bo fn�e enA <br />corrrr( rlll pror(srons ol laws and ord�nancrs povernin,q fhis type o! µ�ork will be cornplofad <br />�rhefhr� sp��cified herein �n nof. The �iantm� ol e pernut does nut �resumo fo yit�e outliority fo <br />woluf�� ,n caricel fhe �rovis�ons ol any ofhm stnte or locnl !uw regu�efing conshuction or fho <br />('PI?Ul/11,7nCP ol C0f15�n�cfion. Thaf I em nidho�izcAby Ihe ownor ol tliis property fo peAonn the <br />work lur �rbich nppficnfion is rnau�� anJ I comply wRh fhe Stato Contiac(ors LnK• 18.27 RCW and <br />296.200 41'AC. <br />/i/ <br />. <br />{� _`�n1 " / � ! i.( ( j .� . <br />SIt1�1:11111P. <br />f-EF <br />� �y'. <br />//77I / � <br />{,� I <br />' 1�J i <br />/ <br />