Laserfiche WebLink
!Jay. ;. 201p 2:44PN li�ht Do:tor 1'�. 7221 P. ' <br /> 1 <br /> �p �25•4SSl•51�1 <br /> �o NbT Y-Q� Ctud <br /> �71 {'L�R. <br /> ELECTRICAL PERMIT APPLICAYION ( <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 88201 ' <br /> 425-257-8810 - FAX425•257-8857—Nnvw.everettwa.ofg <br /> APPLICATIONS ARE AGCEPTEp FROM 8 AM TO q PM <br /> COC45E' 1'�(1A1(Yl �7l_uQC�1t1�(�(•'y�,reB�`^-Q� <br /> PROJECTADpRESS v <br /> OwnCr Mallqddresa City Stete2lp Phona <br /> c/ [] �S <br /> Z O2� 1Zt A Q A �1.� L:,U Ge.{'�' U.7� 1�ZD� "rJ�SI'O1S��- <br /> Tenent MalAddrea� Ciry StalelZip Phone <br /> �� <br /> �.�c� �- �1S.�.z��� ���`-` � ��� mw�n�-�c.�cQ 'Ce�aU�ra��r�-4���� �� <br /> EICC!iCel CJnIfHCto� h1allAddreea Ciy Slele2ip �'{Uv-�� PhOnG <br /> L�c�n �.q�1�"� � Z��Za� <br /> Slate Ucer e Nwnber ConlrTdce of Work � <br /> Co�v�w�e�Uo..4� �-�� <br /> Proposed Uso of Buildin8 Confaet Person (Plan avtew) <br /> Descriplion of Wurk lo Bo Done� UC '� Q' <br /> NOTE; WIRING IN NON-DWELLINGS IS REQUIR[D TO • FEE <br /> BE II!!RACEWnYS,A-0C OR AC CA9LE, <br /> CITY OR[V8R[tt LOCAL 3AlES TAX CODE IS J105 fT /^ <br /> I Aerehy oeri�ly the(f�hnve n�ed and examinod th/s spplicafion and Amo�v�fho Seme to 6o fn�e and G(��-J '— v� � <br /> cor�ucf. Aq prov/slons ollaivs and oro'insnces governini fhis type OfworVr wlll be eompleted , <br /> wheth�rspecil"ad heruin or noL The granfing ol a nemijf does notpresome fo g�va eulhodty to = <br /> Ivlolate or cencellhe proi�sions ol any othersto7o orlocallaw regula7Mg conshuclion or fhe � <br /> perfomiance ol conshuchun. Thet I em qulho�izeAby Me o�aner ef this p�oporty to padomr fhe <br /> `vorklor u�hich epplicatlon Is rnade and I comply�vlih fhe Stafe Con�ractors Law 9827 RCW and <br /> Z� 2 t4'AC. <br /> 4\ { <br /> Signalure Da� <br />