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6420 BEVERLY BLVD 2016-01-01 MF Import
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6420 BEVERLY BLVD 2016-01-01 MF Import
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Last modified
5/12/2017 9:26:26 AM
Creation date
1/23/2017 1:04:19 PM
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Template:
Address Document
Street Name
BEVERLY BLVD
Street Number
6420
Imported From Microfiche
Yes
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CITY OF EVERETT <br />ELECTRICAL WIRING PERMIT APPLICf�TION <br />.TOB ADDRESS . <br />C�I <br />ao <br />E`�t+�._� <br />1��-F <br />� -� � �, <br />p='�4 <br />DATF'�- j/ <br />FEE ��I�J <br />r,i'�E <br />TENN7T - <br />PROPERTY O'dN£R JO � /�%�' SS En-lri l <br />ELBCTAICAL CONTRAGTOR /7U/LiJEit ( � � ��- <br />h/J�c Fn.ti�=r� d ''OQ �i/i-G:�✓i'7 �Ilf w.4- i'.9 �- cyo <br />CQNTEiACTOR' S ADDRESS � C3C jY / <br />Sj/�fET ilo,�ilEss gNo Fo�61' i'i° Ev�/tri� CI'PY ZIP <br />LICENSE N0. �I�����E /E3 /)'74' EXPTR/�TION DATE � D�� �j� <br />� �=Y <br />AOMINISTRATOR <br />VALUE OF WORK <br />(for commerical work) <br />USE OP BUILDINC <br />�, �[ r <br />PHONG NU. 2 � y- � <br />(di� ��ot include taxes) <br />NOTE: WAC 296-46-140 requires that plans for electrical wock at educational, <br />• institutional or health care facilities 6e approved by the �tate of Washington. <br />Applicants with such jobs must ahow tlie State approved plans�before a City <br />oE Everett permit will be isaued. <br />NOTE: Wiring in non dwellings is required to be Ln conduit. <br />WORK TO BE DONE: <br />�' /?S /•'.l%� SC/'L�ICF b i7h` %i�,/-'/r�v �:.�.-F., <br />/ r � <br />SIGNED: ; �./L � _nL �, > ' Df1TE: I!' � -� ' / <br />/ <br />u <br />u <br />
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