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3102 BROADWAY 2018-01-02 MF Import
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3102 BROADWAY 2018-01-02 MF Import
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Last modified
12/19/2019 2:42:35 PM
Creation date
1/24/2017 4:01:27 AM
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Template:
Address Document
Street Name
BROADWAY
Street Number
3102
Imported From Microfiche
Yes
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� <br /> ELEGTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES 5 _ a �_ ,4 <br /> � 3200 CEDAR STREtT, EVERETT, WA 98207 <br /> 425-257-8810 - FAX 47.5•257-8857 —www.everettwa.org �I! 0 S� 1 Zv <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> �lC'�� � .'� �r�('�L.wv�/ <br /> PROJECT ADDRESS <br /> 3/U.(.�. �I��c1T�'��G�n./ <br /> 7 <br /> N ��- . ���5 ����7- u����) �F'� �I w+4 �.������ y15-a�l-l ;oo�� <br /> � <br /> Owner M2ail ACAress �^ ^ Ciry State2p � Phone <br /> J�Q�.. 1�'�('�t'rYwv�� <br /> N,..l.� •�C�{S C✓v�l i r- U✓1 � u ✓ F!/41-a�- l.l.�/'9 �f�.���I <br /> Tenant MailAtldress City Stale?.ip � Phone <br /> .ZS <br /> -�L 5�a�, F�,••-/,h,�� g�<- ��"'"5r- /ci,r�r�. �vr4 4��'�3 8 r <br /> � �(J <br /> {s_r�=—'--7 <br /> ElectricalConlrador MallAddrese CRy Stetel2ip Phone <br /> 5����,.� F * � o:z ,sa /.S.Gn <br /> State icenso Number Contred Price ol Work <br /> ��l �"f.�A �I�M 6���n n✓Z <br /> Proposed Use uilding Contad Person (Plan Review) <br /> Description o1 Work to 8e Done: IL��"'�c�v� � Ly( (S�I Md ZLL U W�v�l�I� W9'�C. ��qi� <br /> aK�' 2Ns7��.�L �,7 �-ew .?Zt��.,,,��,o� u�a�G s�F �ts c 5��� <br /> Lv��r�v o r✓�5 <br /> NOTE: WIRING IN NON-DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS,MC OR AC CABLE. <br /> CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I here6y certify fhaf 1 have read and examined fhis application end know fhe same fo be true and <br /> correcf. All provisions o/laws and ordinances goveming fh�s t}�pe o/work will be complefed <br /> whefher specilied herein or nol. The granling ol a perm�f does nof resume lo,qive aufhorify to <br /> �iolafe or cancel the provisions ol any olher sfafe or local law reguPfing r.onshucfinn o�Nre <br /> peAormance ol tonsfrucfion. Thaf I am aufhorized by Ihe owner ol fhis property lo perlonn fhe <br /> worl� lor which applicafion is mado and I compty wifh fhe Slate Confracfo�s Law 18.27 RCW and ��i <br /> 296200 WAC. �, I <br /> � .�1i2��'17zzs�vl� s—�2�1G <br /> �� D <br /> / <br /> SgnaNre ie <br /> J� <br />
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