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zet.22. 2i'12 S:SSAM %-..4473 P. 2 <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ir mil <br />PROJECT ADDRESS <br />$ARRA&/a G+snStJ JSoI (ro14 sr 5E -'PV�e�-T WA- 9B.Po3 �415�358 Dalb <br />Owner Mall Addross City StelalZib Phone <br />Tenant �/A Mail AddMas City SlmelziP Pnone <br />�oollaC : cLrrycTttc Lac - 50o G rAAN s,-. Nord-oE 1AIA 98a�a�vss)9s�•k4n2 <br />Electrical Contractor Mall Address City SlatalZlp Phone <br />(2,5NTC-SI1930RIt __ <br />031.)-4-T e— <br />Stale License Number Contract Price of Work <br />0Cc%. PtED P1.5 rJC� _ (1ft�g zxtwAtr,�o (495)5�8- Saga <br />Proposed Use of Building Contact Person (Plan Review) <br />Description ol Work to Be Done: UPC(�DOV4RN'rJElFr1 SE°JtC_E "°M <br />��SM PVVD AM t° -- <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE aa..�� <br />BE IN RACEWAYS, MC OR AC CABLE. W <br />CITY OF EVERETT LOCAL SALES TAX CODE 15 3105 <br />I hereby certify their l have read and examinod thikapplication and know the some to bqtrue and I ZD L l 3 <br />correct. All pttQstons gr laws and ordinances povehiin this type of work will 6e completed <br />whs(her spectfiad herein or not. The granon9 0l a perm9t doe! not Presume to glue authority to <br />vio/ore or cancgl the provislons of any other stare or local law Isgu/sting construction or the <br />parlor ante of conshuchon. That 1 am eufhonzed by lhu ownefOf this rOperty f0 perform the <br />work for which application is made and I C m I with the State Contractors Law 18.27 RCW and <br />206.200 W� <br />a-i,,Po-- la <br />Date <br />ignatura <br />