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Jan, 30. 2014 12:05PM No. 1687 P. 3 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVFRETT, WA 98201 <br /> 425.257-8810 - FAX 425.257-8857—wvvw.everettwa org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> C IUD I -IS I <br /> PROJECT ADDRESS <br /> ' lU_�` frin (.P, SUIWc. QS c�i'JZ�/P�_ X25355 f1o73 <br /> Owner Mall Addross Gly slale"ZO fh-rn <br /> Tenant Man Atlereit Coy 5181ei:,p Fh:ne <br /> W I a�1 li�c, 1415 gr�dua�Ev_ex�it wAgB2Q1 x+25 2`iCb,6,L4_ <br /> Electrical Contractor Mad Adless City Slalc/zip Phcne <br /> Cfy1-NEAMHg0IGq _ 250 r <br /> State License Number Contract Price of Work <br /> Proposed Use of Building {J�� Contact <br /> ,Person <br /> �(Plan <br /> ,Review) Y <br /> Description or Work to Be Done. r1 Cju 1 I Yi�C4 1 Vpt. <br /> NOTE. WIRING IN NON-DWELLINGS IS REOUIRF0 TO FEE <br /> BE IN RACEWAYS.MC OR AC CARLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 310S <br /> I hereby certify that I have read and orarnmad this application and know the same to be We and C 1 O ) I I <br /> correct. All provisions of laws and ordinances overmng(his type of work will be completed L I I <br /> whether specified herein gr,not fie ranting Sf a permil does not resume to give euthonly no <br /> wolale or caneri the provisions of anlether state or local law M urating construction or the <br /> pe omranps o cons ruction. That I em authorized by the owns 0f(hisproperty to perform the <br /> wak for which application is made and I comply with the Stere Contractors Lew 18 27 RCW and <br /> 296.200 WAC. <br /> Sipnalum Data <br /> 1 J <br />