Laserfiche WebLink
( <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 C[DAR STREET, EVERETT, WA 98201 /i-ly--o 6 <br /> 425-257-8810 - FAX 425-257-8857—www.everetlwa.org ��6 �� _� � <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ��5 0 / SN/�20/✓ l���r%.�= <br /> PROJL"CT ADDRESS <br /> `��C / Sf/f72a�✓ I�/Z C b�t/trf �Z�lJ <br /> Owner htail Address City State/Zip Phone <br /> Tenanl Mail Address City Slale/Zip Phone <br /> ,��9RBOa� Z Yp •v� E �%riitit !i✓G (i'ILY -/�P � S7SGJL {��NN'J•:OWi7 ��'�'�/ ' �IS'JYl- <br /> Eleclrical Contraclor A7ail AdJmss Cily State/Zip Phone 72 � <br /> ��9i�Bof'r�JC+�/4�{� �/�'��. n o <br /> Slale License Number Conlracl P�r��of Work <br /> Proposed Use o(L�uildin� Contact Por„on (Plan Review) <br /> Uescrip�ionofWorkloDeDone: -.1r",-C �1i'��� i•-�'� < < (� �;•'aNy�C <br /> 1� (U�J 67Ra �6 � <br /> CSSi/iiN L✓ JLt d� /�i17!/iZf' h p / A 1 L�v /CFO �t <br /> i �' <br />\ NOTE: WIRING IN NON-DW[LLINGS IS REQUIRED TO FEE <br /> R6 IN RAC[WAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heroby certi(y U�af 1 have read and ex�ntined this applicafion and knoiv(he sante to be fnre and ���� ��-pe� <br /> correct. All provisions oll.,�rs and o�dinances c�overnm�fhis t}�pe ol work will be completed <br /> �rhufhcr specdied herein�r noL The c�ranting ef a perrnif does not resume to give aufhonty to <br /> violate or cancel fhe prav�sions ot any other state or locnl law reguPfing conshuc6on or fhe <br /> pedonnance ol conslruction. Thaf 1 am aulho�ized by the o�rnero/tlus property to por/omi fhe <br /> u�erlc/ur�rhich applicafion is made and I comply with the Sfnfe Confmctors Law 78.27 RCW and <br /> 28G200 IVAC. <br /> �'�� '{' Q ��1n ���/�. �r �. <br /> ---- Sic�nature Dale <br />