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[t4�17/2012 14:32 4254854320 HILL ELECTP.IC PAGE 03/04 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERET7, WA 98201 <br /> 425-257-6810 - FAX 425-257-8B57—v�nvw.everettwa.arg <br /> APPLICATIONS ARE ACCEPTEP FROM 8 AM TO 4 PM <br /> � <br /> 381(� SM,-�h A�� �ver�l�+- WA 9g�-� 1 <br /> PROJ[CT nDDRESS <br /> Ovmer Mall Aatlress Ciry StatelZiD Phane <br /> I Tenant I.teilAtltlre55 C�ty SIBtO�Zip Phone <br /> {��II E�ec-+r�c— i'o (30X 104� Wood;nv�ll� Wft Q'd'v�Z tia�-4g5-43ai <br /> EleClncalConlractof MailAddress City State2ip Phane <br /> I-II LLEC � o�s6°I � 4� 99a. °° <br /> Slatu License Number Controct Price of Work <br /> � Roqer N� II <br /> � S�I�c�a � <br /> � Proposetl Us� 8uilding Contact Person (Plan Review) <br /> I <br /> � � r <br /> I DeScriplionofWorkto�eDone: �e7�i���`n �'`���`'v` QC� �r� �'�� �`�����j '� <br /> C`�'cJ�`�CH �� bc�n c� ��i��t J <br /> i <br /> i <br /> � NOTE: WIRING IN NON-DWELLINGS IS REQUIRFD TO FEE <br /> EiE IN RAC[WAYS, MC OR AC CA6L6, r. <br /> `t�� �--� J� <br /> CITY OF EVGRE7T LOCAL SALES TAX CODG IS 9106 <br /> I horeby ccr,ify lhot 1 have read and examined this ap�lrcatlon and kno�•�the same!o be true snd <br /> correcf. All p!ovis�ons pf la�+'s and oidinances[]ovemm9 thir type cf work�t•iif be completed ,— <br /> whetnerspec�fied herein or not The granting e'a pennR doos not presume fo give authonty to F— �,�G�—(;f�� <br /> violafe or caruel the provisions o(eny other stnte orlocel law mguleting constructlon or the <br /> perfoimanr.e o(cons(rur,6en. Ihat I am aufhonzeAby(he�ot�nor oflqrs properly fo pedorm the <br /> work(or wRich appOcaPon is mada and 1 cempry urth tha Stafa GonVactors Law 18.27 RCW and <br /> 296200 WAC. <br /> � �..�r�L. `f-I�-1 �-- <br /> Sig aW e palC <br /> 1 <br /> I <br /> � � <br />