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10606 20TH PL W 2016-10-18
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10606 20TH PL W 2016-10-18
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Last modified
1/13/2017 3:17:06 AM
Creation date
10/17/2016 10:59:09 AM
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Template:
Address Document
Street Name
20TH PL W
Street Number
10606
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� <br />ELECTi�ICAL ��R�VfIT' APpLIGATiON <br />GlTY OF EVERE'fT' pEl�MIT SERVECES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257,8810 - �AX 425..257-8857 — �nryyUy.everett�nra.org <br />� ��o O l� p�,1. � <br />PROJECT AbpRE3S <br />�- � 0..r c.h <br />Owr�er <br />T'enant <br />�iectrtcal ContraCfor <br />Mall qddrass <br />Mail AddrBss <br />�� <br />�laif q�dress <br />Q to� �u <br />State E.icense Numbet (required) .." �-- — <br />Prpposed Use of Suilcftng <br />Square �ootage (If resident�af n@w conshuctior�, rernodel �r addifionj <br />Number ot devices (ff Iow voitage} <br />Description of Wo� � ge Dane: <br />..a— 1„ . ,� � <br />C�TY OF EVEFZE7"T LOCAL �q��g �qX COD� t3 �105 <br />City <br />�Y <br />Clty <br />b. 3 e . ( <br />StatelZip Phone <br />�8��p PhOrse <br />1 �08 b � � <br />St�te/z#p <br />Phone <br />oa a 3 Q <br />City of EVere�t �usinegg LiCensp EVum�Pt (r�qufred) <br />� �3bo <br />Contr�ct Price of llyork <br />Contact Pe o ICon� N mb��m��' � O <br />� rcU;-�-s : <br />I he�ghy CB��y, that l haVe �g8d and eXemined this appl�cabon and kndw the same fo be irue anci <br />°O� A�� provisrons oflaws anr� ordinsnces goveming this type of worlc �fl be cotnpleted <br />►'�hethe� specitled hereitt or not The g�nFfn� oF� p�1t does nnt presume to g�ye �ut�rnMy to <br />vlolate or cencel the provisions of ar7y oth� State Or JoCa! laW r��a��y �n��,�l� or fhe <br />PerfofT178nce of Constructlon. Tha# 1 em eufho»z�d by t)re ow�cr of tllrs proPeriY to Polform the <br />work for which applrca#ion is made a„d I compl}• with the Stste ConiraCtors L8►y 7g,,�� RC W and <br />'�9�.2D0 Wj1C. <br />1 <br />R��S� o��Q,a <br />r <br />F�� <br />��,, c� <br />P�RMIi# <br />E � � (��-��� <br />
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