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12/28/2000 10:28 FAX 4253357830 VARNELL ELHCTR1C Q002/002 <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.everellwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> to ZZ ,OOTR ST SE <br /> PROJECT ADDRESS <br /> 3100 11- 54 518 1 <br /> _F. r�t,s.s�Gourlsn.�Sra_�.lrr p n fox 13y 4 Mw..c>•r vt�te ILJh. 4 Q Z-►� <br /> Owner Mall Address City state/Zip Phone <br /> SA Adl r <br /> Tenant Mall Address City St3to21p Phone <br /> LLC <br /> SCyor.A C Ws 4RtrA <br /> riectrical Contractor Moil Address -Ity State/Zip Phone <br /> t 12 c 0-2 <br /> State License Numher Contract Price of Work <br /> G! 4F� <br /> I'repo ed Uso of Buildllrg Contact Person (Plan Review) <br /> Ueacdptlon of Work to Be Done; C d fk , t¢ &rsewl D paAr <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALE8 TAX CODE 18 3105 <br /> I horoby certify that I have reed and examined this application and know the some to be true and <br /> correct. All prpvisions of laws and ordinances govemig,this type of work will be completed <br /> whether spec)led herein or not. The granting of a permit does not presume to give authority to <br /> violate or cancel the pprevislons of any other state or local law regulating construction or the <br /> peAomrenc?of consWction. That I am authorized by the owner of this property to perform the <br /> work for wh ch application Is made and I comply with the State Contrac(ors Lew 18.27 RC W and <br /> 296.200 WAC. <br /> Signature 2 wale <br />