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I ELECTRICAL PERMIT APPLICATION <br /> C�TY OF �VERETT P�RMI7 SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - F.4X +25-257-8857—www•everettwa.otg <br /> APPLICATIONS ARE ACCEPTED FROM S AM TO 4 PM <br /> l l 3�� �=`' ' �.`" <br /> � � � 9��Y' <br /> PROJ�CTADDRE9 ' <br /> Owner Mall aadress <br /> Cily S;atelZlp PhOna , <br /> �� 5�7� <br /> A �� M=11 AdCress Ci�' SlatefLip P�� <br /> Tenant <br /> • , r 2oi� !�'1��..� � � c✓A 9�Ds'G <br /> � ���, Stete2lP /a����� <br /> Electrical Co rector A7ail Flddress <br /> � g/STN o Doa ' <br /> Q��� Contract rlce of Work <br /> State License Number � <br /> G� � Contact Person (P�an Roview) <br /> Proposed Use of 9uilding <br /> Description of Work to Be Done: . � <br /> � <br /> NOTE: RERN RAC WAYS M�C R AO CABLEUIRER TO <br /> FEE <br /> ��7y OF EVERETT LOCAL SALES TAX COD�IS 3f OS <br /> 1 hereby certlly thsf 1 havo read and examined this appllcation and know the same to bo frue and � � / <br /> iiheherspea�ed hci inror ot�The��ranfing o e permif�oesYnolp resume to givs eufhorry to �'� U ' _` �� <br /> violate orcancsl fhe�rovisions o��ny other slafo orloca!law regulatingFconslruction or 1ho <br /> p o�k f�or�whl ch apgl cetiotn/s�mado�ad�l comp ye�trh fhe 9ta(e Cent�e[orspLaiv i8pe7 RC W and <br /> WAC. <br /> � y Z,i,� <br /> �at <br /> Signature <br /> �/ I��S�Q CW�^ W t� �c�lX� l. CN'.✓27i I v1.�1•vl-w��^Oa'1 . <br /> y ZS' �?" &Fllolo <br />