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9107 9TH AVE SE 2016-08-31
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9107 9TH AVE SE 2016-08-31
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Last modified
1/12/2017 11:28:55 PM
Creation date
8/31/2016 3:23:32 PM
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Template:
Address Document
Street Name
9TH AVE SE
Street Number
9107
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� <br />LECTRICAL PERMtT APPLICATION <br />GiTY OF EVERETT P�RMtT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 4�5-2a7-8810 j FAX 425-257-8857 ��E) everetteps@everettwa.gov ( www.everettw�a.gavlpermits <br />CO�tTACT 1NFORMATION <br />. <br />OWNER NAME: .��r ,,�, T� ��, . C,+ CG� l�. �i j TENANT NA�AE (If Cammerciall: <br />!G ADDRESS: srnFei <br />cm <br />- �.�G vz � ;'� <br />NAME: �tf ' <br />ADDRESS- srnee-r <br />CfIY <br />RACTOR PHOf�lE: ��,Z.O6� �,�6 � <br />�S <br />/ � <br />t G �i� -1 :' <br />io2-T C� rP <br />SiATE <br />e �� � , ,�- � <br />EMAIL..._.���r.-�..�� ��"��.,-��k <br />� .�� �� �t�' <br />SiATE �%�Ti <br />�CTOR EMAIL: „?�/�i f� � � r' .'1'�f. .�i" <br />ZtP <br />!i ' . <br />ZIP <br />CONTRACTOR LIC. #(REQuiRED): oGG/ � � C_ �, `iG� CITY OF E'VERETT BUSINESS LIC, REQUIRED): <br />PRIMARY CON'E'ACT: � pWNER ,�CONTRACTOR ❑ OTHER {Ptease Specify} <br />CdNTACT NAME: �1�� CONTACT PHUNE: ���, - �S"�I � <br />COIdTACT EMAIL: ' <br />` s v -r' G �i! �' - �� �'�l ' ,� . ��;%��? <br />A6REEMENT.• T her+eBy cert�j� ft�at ! have read and examrned this appltcatiorr and /vtow the same to be hve and correct. AN provisions of ta and oraFinances gotreming this <br />type of warlr wil! 6e comphrted whetherspecified herein or not. The gran#ng of a permit does not presume to give avtha�ity fo violate or camae! the provfsions of any othe� state or <br />local law reguta&rrg construr.tivn or the per/omrance af constructivn. Th� f am authorized by �e amler of this prope�rty fo perfam the wnrk for whFch appfication is made and I <br />compfy with the Stete ConhaCfas Lew �8.27 RCW artd 296.200 WAC. <br />City of Evereft OflSeial tlse Qnly <br />FEE <br />�� 0�,�% <br />PEF2M�T # <br />E 1 0 L� -� <br />(Revised 1LV12/2015) <br />
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