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05-91- 20:2 16:28 FAS 42595J89Jd Ecer6reen Securit,� �002 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 9B201 <br /> 425-257-t3870 - �AX425-257-8857—w�w+•evereriwa.or,r, <br /> APPLICATIONS ARE ACCEPTED FROM e AM TO�i PM <br /> ^ I� � �� <br /> PROJECT ADDRESS <br /> i� <br /> Owner Mali aaernss Cfry StatwZ�p Phwm <br /> �� �l(JY�-+"7YLSQ- �\(1 i ��i <br /> 7enant Mall Address U Gy SWte2Jp Phone <br /> ��t2s�3��-�s� <br /> U..t,�, �101 ��f k7�1 q.gZ,A� <br /> Eleclricel 3G10f MnilA ef 5 CRy Slale2ip Phone <br /> .-���s-s� ia��. ���.�,� <br /> Slate License Number Contrad Price of Work <br /> �� ,��V/Y l/1_� (�lit/� l.l.� � ��l�'� I <br /> ProposedUse of Building Contact Person (Plan Review) <br /> Description o(Work to Be Done� �In�� � ` 1., "7�' "-'� n'Q a'V � 1 C`^^ �"����_ <br /> �� l a. v`�.1�\ '�3'ti'blxS. 5 �.--�-�- 'S�"��s � l2 Do�r c.�r�.�•-� <br /> a� ��'� Cc�--�s 6� z s�vl.�-�r.a.� ��.o� <br /> NOTE: WIRING IN NON-DWEILINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CAI3LE. <br /> CITY OF EV[R[TT LOCAL SALES TAX CODE IS JiD6 <br /> I hereby,-erlAy Ihat I hr�ve read and�oxamined fhis application ond know fho aamo lo be frue and J f�)� -� ��� <br /> GOnxcf. h�provis�ons ollows ond ortiinanros goveming fhis fype o/wor'k wlll Do cemplefed ��� <br /> wh�fher s���cdied be�ein o�not The,qranting o/a permrt does nof prosume fo giw avfhonry ro <br /> vi�lafeor,;ancollhe provisionsolanyofhorstafoorlocallawrogulalingcnnstnitbonorfho <br /> peAomio of oonstruction. ihaf I am au(honzotl 6y No otvner o!this praparty to peAorm fhe <br /> �wrtr w1u epphcation is mave and 1 mmply�vifh tho Sfafo Contraclors Law 1ti 27 RCW end <br /> 29 00 W , <br /> S 3l I ?�- <br /> Signaturo Date <br />