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� <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM <br /> 3 �3 t � S�.,; tl� � � ; ���:ti-, t.�.�h � ���.c i <br /> PROJECT ADDRESS <br /> � <br /> 1-(�ll Shrex-� "�,wi�.�� �33�L Mk�A«.�.Qp-ax, E�,-e+t, wrE� `�Szc( <br /> Ownef MailAtld�ess Cdy State2�p Phone <br /> I�cyzll 1,t.'�.�n.l�us 3g�7 S,�;tl� �1�� G�-.�e.tt, �'"+� , R82�� — <br /> , <br /> Tenant MailAtltlress Ciry StaleQiv Pnonr I <br /> �ua��l�ah Se�,,-� h�, 17�� � sr � S� Se<<til� t,�'tl, 93134 tzcE�35`� iZ�3 <br /> EleeiricalConlractor I.ta�lAtldie,s City StatelZip Pn-i�c i <br /> G ua•^d SS2_z Z VZS 3, ►oC� — <br /> State License Number Comract Pnce of Work <br /> R«���>�;r tc� F� <br /> Propesed Use of Buiiding Contact Person �Plan Rewewl <br /> Description of Work to De Done�. \ �� ��u^'��^'� 5�^C t�M.� : F1�CL �✓�c � <br /> � <br /> ���Llf?tf�C � ,ls� <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RAC[WAYS, MC OR AC CABLE <br /> — — -- — I <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 i <br /> I hereby ce�G�y fhaf I have�ead and exarnined this applrcnhon and kno�v fhe san�e to be Inm an�t � <br /> conecf All provis�ons olla�vs and ordinances governmg Ihis lype ol nork�•.,u be cornp;etec' <br /> r.Lelhei speciGerl heroin or noL The granLng ol a pennR docs notl��esunie to yrve aufhonty to /'� I I i <br /> oiolale or cancel the prav�sions o/any olher sfa(e or local lau�iegu aling conslruc6on or fhe ('1 nl�� <br /> p,;r{�rmance o(wnsGuclion. Thal I am authonzed by the o�rner o/(b�s properly fo peAorrn fhe \/ 1 I <br /> v:oik lor..hicb aUP�icalion�s made and 1 wniply�vRir Ihe Stafe Conliactors W�v 78.27 RClNand 7�� <br /> .'96.�001VAC. V <br /> I �___ <br /> l�s'�-� oq i ��r�o � <br /> � S�gnaWre Date <br /> I <br /> I <br />