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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES y_,�-�o <br />3200 CEDAR STREET, EVERETT, WA 98201 � �oOR -o5G <br />n, '�257-Sb10 - FAX 425-257-8857 - �vww.everettwa.org <br />APPLICATIONS AR! <br />S I � li, . <br />� I �� ' � , I <br />PROJECT ADDRESS <br />CEPTED FROM 8 AM TO 4 PM <br />,n <br />' l'J�I," '�, � I", l.L. l� l� Ll,� �'1 C�'f .%-''' � <br />i� � <br />Ownar Mall Addross Clty Slate/Zip f-hone <br />Tenant <br />[leclrical <br />Sln�e I.ic��nsi• Numbcr <br />hlail Address <br />Atall Address <br />i <br />�' � � l k <br />Propu<<�d llr �, ul �vdding <br />Clly <br />Clly <br />Slate/Zip <br />Slatc/Zlp <br />r � <br />�� ( U�' - <br />Contracl Pdce of Work <br />Conlecl Porson (Plan Roviow) <br />f)cs� ri��li� m i4 �Vofk �o �O DOno: � �� _� I c' �' t� S�` - .�1 ����,;i,�__— _. <br />NOI F: WIRING IN NON-DW[LLINGS IS REQUIR[D TO <br />BC W RACEWAYS, MC OR AC CA[3Lf_. <br />FEE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />i , <br />1 he�uhy r,ertily fhaf I linrr renJ.ind ��x+�nunad fhis nppli ��non �ind knon� Iho sen�e to 6� 6uc ond �.I U�% ,- .' �.- <br />carrocf. All provl:ions olln�vs and ordmancos c�evamnf fhis f��pe o/ �ti�ork will be complefFrl <br />whelhei speci6ed herein or noL Tfm rpantinr� c/ a perm f does n�f �msumo (o givo nufhori(y lo <br />violalo or cancel Iho {�rovisiorrs ol eny ofher sfetr, er Iec,J Imv regu�nfirtg consfrudior oi Ihe <br />perlorrnnnce u/ consf�uclion. Thaf 1 am eufhorized by fhn o�ti�ner o! Ihis property fo peAonn Ihe <br />�vork for �shir.h npplir,;rtion is rnado and I compty wifh fho Sf..'7 Cenfrt�ctors Lr+w 1Q.27 RCIV and <br />79fi.700 lM1'AC. <br />I iy <br />_ ------- - ---..... ..--- <br />. , � 2,u�. I)n!o <br />Phenc <br />Phone <br />