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ELECTRICAL PERMIT APPLIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEI?AR STREET, EVERETT, WA 98201 <br /> 425-257-fi8?0 - FAX 425-257-8857-www.everettwa.org a. �I g O 9 <br /> APPL�CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �'�G7 'U� <br /> ,��/� �rI i rH �dENVE <br /> PROJECT ADDRESS <br /> �"f//� �sTF/' .3�i� S,�rr� ���a�- E�F���r--G�J� ��s•asa•.� <br /> Ovmer Mall Addreas Clty State2ip Phone � <br /> Tenanl MailAddress Ciry State2lp Phane <br /> ��.��/.1/��lbP.��/�1/G �.,�u'!9� /1/A.er�sT�i� ws� �P�� ..�o.�._:9 .3- <br /> ElectrltalContractor MeilAddresa Ciry � State/Zip � Phona <br /> G'�.�///6" ,�/ C� ��'SDD.o0 <br /> State License Number Contracl Prico of Work <br /> �,9/JL �iF�.cw�T�.� <br /> T <br /> Proposetl Use ol Uudding Contacl Person (Plan Review) <br /> Description o(Work to Do Donc: �� f�DO/TIONiqL C:/.C>�/TS �,C'. <br /> /�a��T���,�-� Gi6,��s <br /> NOTE: VNRING IN NON-DWC-ILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLF. <br /> CITY OF EVERf TT LOCAL SALES TAX COD[IS 310G <br /> 1 ho�eby cotliryY�af I havo read and ezamined fhis appl.'cation and know the seme to bo fruo ontl <br /> cormcf. All p�ovsions cllaws antl orti�nencos oovemmq th�s typo ot work will be c+��mplefod <br /> whelher speci�ed hernrn or nnl. rhe granting o!a pernrt does not resume fo gi�n aufhonty fo <br /> violate or cance!Ihe prt+visions ol any ofhor slato or local law roguPting consWe6o�or fhe <br /> pnrlormanco o'��onstruCtion. Tha(I am authonzod by Ihe owner o!this propeMy to peACrm fhB <br /> work/or which applicofinn is made and I c,romply wifh fho S'afe Contracfors Le�v 18.27 RCW and <br /> 29fi.200 tNAC. <br /> I ' <br /> I , � a-�,�-49 <br /> 5gn3ture ate �� <br /> �� _ i <br /> � j��l <br /> IOOiI00� .lXl .I.S'rl .\�nn�J SCt6CS�300C S1':1 7S�tl GOOi./AI/i.0 <br />