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ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES ti <br />3-00 CEDAR STREET, EVERETT. WA 98201 ' <br />aI- <br />425-257-8810 - FAX 425-257-8857 — vdww.everettwa.org C I I n 6 —1 �3 <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />C'C <br />cJ0 (j <br />PROJECT ADDRESS <br />.1)�/l �'.9d�/ i �9L / / G /�,M) In—VA6NE l�✓e STrINW-01), IAA Owner e <br />City State,Zlp / <br />Uwnor Mall Address if Z) — Z � fG Z <br />Tenant Mall Addrosa Clty Stale/Zip Phone <br />c L r Phone <br />Electrical Contractor Mall Address City State/Zip <br />State License Number Contract Price of Work <br />Proposed Use of Building Contact Person (Plan Review) <br />Description of Work to Be Done: _( iy, iT1t%/� <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 3105 ��' <br />1 hereby certify that I have read and exams nod this application and know the some to be true and VW o" <br />correct. All provisions of laws end ordinances goveming this type of work will be completed <br />whether specified heroin or not. The granting of a pemuf does not presume fo give authority to <br />violate on cancel the provisions of any other state or local law regulating construction or the <br />pedomtance of co ll anfionols made and I authorized <br />omply wltlbiyflile Sfefe owner Of 1B 27 RC W and <br />work for which ppp <br />296.200 WAC. <br />Signature <br />