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12/11/2006 13:09 4254885288 PAGE 01/01 <br />HLiU-14-1:14 I-K-I AU:42' K, V.Vh{ btiKVIUV. i )'HA NU. 4; 4C�YJt1d91PICl I,:,;:ac tiu. Y, w7;r.<I I_.r <br />t <br />ELECTRICAL PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES / Z-17 -o 4, <br />3200 CEDAR STREET, EVERETT, WA 98201 L b� Z _a 6C� <br />425.257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br />l ollo�FAl►� r <br />PROJECT ADDRESS <br />Owner Mall Addreas City Stateizip Ptwne <br />42g <br />�}z ii� �f17�PaS IDIiO •Eml�E�102eC� WN ,3/;.-104 <br />Tenant Mall Addresa City State/Zip Phcne <br />aorta_-1 W� <br />AEj vices 116Z4 �1 cagEv Pv-w� ls *I06 c1m11 h?s �FLES.5;* <br />Electrical Contractor Moll Address City Statomp phono <br />t-��`iS 5G5-L03,7-0j 1-25.'04 dire yf`Q©•G� <br />State Llcenae NUmber Contract Price of Work <br />W06 &x yys- VS. Y-sysl9 <br />Proposed Use of Building Contact Person (Flan RCVIOW) <br />Description of Work to So pane: ce'Ty CjWW-4-S <br />NOTE: WIRING IN NON -DWELLINGS IS REQUIRED TO FEE <br />(Be IN RACEWAYS, MC OR AC CABLE, <br />CITY OF EVFRETT LOCAL SALES TAX C008 19 3105 <br />i Nvt oby certify that I have read ottd oxamined this application and know the same to b trite and <br />con•ect. All provislonn of laws and ordinances governing thls type of work will be cornple ed <br />whetherspeo,ried hatoon or not. The granting of a permit does not Fresume to give authority io <br />Oolate or cancel the provision; of ony other state orlocal taw regulating construction %the <br />performance of construction. rhnt I rim authorized by the owner of this rnperty to Pe o floe <br />k9odr 0 which <br />appilcoUnn Is mode and I comply with the State Contractors Law 18.27 RCW and <br />���ianalure � Oato <br />f <br />