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r <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 <br /> -19 76 '"- V• S.d . 9szo3 <br /> PROJECT ADDRESS <br /> Owner Mall Address CRY Stalealp Phone <br /> T -/Y/ OVII(7 <br /> Tenant Mail Address City State/lip Phono <br /> �cW1&(tir2 C1cLk Po wA %07 <br /> 746 7r809L <br /> Electrical Contractor Moll Address �nClO� Slatej7,p Prone <br /> S(✓F_Ie 1 9S-3 PW - <br /> State License Number Contract Price of Work <br /> ul stye TACOE Son iBr�� <br /> Proposed Use of Building ^ Contact Person (Pen Review) <br /> A <br /> Descr,ption of Work to Be Done: d d rr 7-go ✓ Zo A G112,cl-' 7o M!. eg,'La- <br /> NOTE WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3106 <br /> them certify float I have read and examined this apdico0on and know the same to be true and p� Q <br /> correc[ All provisions or laws and ordinances governing this type of work wilt be completed <br /> whether specoll d herein or not. The granting ofa pormd does notpresume to give cufhority fo <br /> violate or cancel the Provisions of any other state orlornt low regulating oonsfnrchon orthe <br /> perlormnnco M conaruction. That lam authorized by she owner of this property to perform the <br /> work for whichpplIcation is m and I comply,with the State Contractors Law 18.27 RCW and <br /> 296.200 VSA <br /> y/�Y/o9 <br /> gnalure Date <br /> I'd 8098 88L 9Z6 ieuquog e0ef d85b0 60 til AV <br />