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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CFDAR STREET, EVFRETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — �v�vw.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />.c- � �7�. "71, <br />� !,.' <br />PROJECT ADDRESS <br />VL-I-.ti�,� �til�,tir.,l`� �'�l '>I IL'!`�;n f'l ` L �l.t:Gli l�L��1, 7��b�� l�S�-5�7, <br />Owner Mall Add�ess Clly Slale2lp Phone <br />Tenanl <br />6ledrical Conlractor <br />Statc Lii:�mse Numbcr <br />Pro����sr�d U�u� u' f3uilding <br />Atail Addross <br />r.1;u� nddrass <br />City <br />� <br />Stalo.�l�p <br />SlataZip <br />�nninct Pricn ol WorM. <br />Contact Pcrson (Plan Review) <br />Phone <br />Phnnr <br />f1��sui��Ir��nolWorAlo�oDuno: �/��5%����- LV� Q�N%� t�II�CVII 15��..��`��' .�iiC,���� L�C. <br />ill_/�l: <br />NOT[: WIRING IN NON-DW[LLINGS IS REOUIRED TO <br />�E IN RACEWAYS, MC OR AC CACiLE <br />CITY OF EVERETT LOCAL SALES TAX CODE IS 9105 <br />I heioby crrtily fhnt 1 hm c� feail nnJ �a�inunoJ fhis apple ah��n and hno�r fhe same fo be 6uo nnd <br />corzrcf. AB p�uvisiuns of laws nnJ o�Jmancos yorenun�j fhis t}�pe o/ �rori� �vdl be cornpR�fei1 <br />�i�hefher spaci6ed hervin or nnL Tho �7rnnfin� o! n permd dons not nesume to gice �uthonfy fo <br />violuf�� or cancei the provisiens o/ any ofher slafr or local la�v repu�nfm,q cunsVucfion o� fire <br />perforrnence o( conslrucfion. rhnt I ae� nidhonzed b�� fhe o�rnor of Ihis property to pr+rforrn the <br />�so�k lor �vhir.h nppNcafion is mndo and 1 rompl�� �rifh fhc Sfnle Contrncfors 1_aw 1A 27 NCl1' ond <br />19G.200 l4'AC. <br />f"EE � <br />���(I.�i� �� -'�,,.�./� � -�-ZQ�/�% <br />9iiplaturu Uale <br />� �: � <br />