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ELECTRICAL PERMIT ��PPLiCATIt,�N <br /> CITY OF EVEl2ETT 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 8 AM TO 4 PM - DEBIT & CREDIT CARDS ARE NOT ACCEPTED <br /> 3� 2 � �.�M ���n <br /> PROJECT ADDRESS <br /> SGU1Ju V�L�J C� N ) 12(�l� Oi2S S' �� � 7�— �7-a-y7 <br /> Owner Mail Address Ciry Slate/Zip Phone <br /> Tenanl Mail Addr ss Ciry StatelZip Phone <br /> P1�� C�rN� ��E�J/t/C <br /> Elec,rical Conlraclor Mail Address City Sta:e/Zip Phone <br /> j� CC� /N LCa� 3 N.i — <br /> State License Number Contract Price of Work <br /> Proposed Use of Building Conlact Person (Plan Review) <br /> Descriplion of Work lo Be Done: � - � � � 1 Q �� � �—CL��, <br /> NOTE: WIRI�G IN NON-DWELLINGS IS REQUIR[D TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 � <br /> 1 bereby certily that 1 have read and examined fhis applicalion and know fhe same to be fnie and <br /> correcL All prowsions o(/a�vs and ordinances gevemmg this fype of work wi;l be corttpleted <br /> whether speciGed herein or noL The granfing o!a permd aoes not presume fo give authonty to <br /> violate or cancel fhe provisions ol any other sfate or local law regulating construcGon or fhe <br /> perlormance ol consfrucf�or,. That 1 am aufhorized by fhe o�vner oI this property lo perlorm the <br /> work(or which application is made and 1 comply with Ihe Sfate Contractois Law 18.27 RCW and <br /> 296.200 WAC. <br /> �� � -�/ �/ - 2 - C15 <br /> 1 � � — <br /> , <br /> �-� i9nature / _�� Date <br /> ��//- Oo� <br />