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4910 BLACK FOREST LN 2016-01-01 MF Import
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4910 BLACK FOREST LN 2016-01-01 MF Import
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Last modified
1/30/2017 7:16:48 AM
Creation date
1/30/2017 7:15:43 AM
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Template:
Address Document
Street Name
BLACK FOREST LN
Street Number
4910
Imported From Microfiche
Yes
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/ <br /> CITY OF EVERETT DA7E: � �� ��� � � � <br /> 0.ECTRICAL WIRING PERMIT APPLICATION F�_; <br /> �7B ADDRESS '�9 '� <�=��� Fp�?s � � , ..,r. <br /> TENANT <br /> PR�E'rtTY OWPER L � .� �n�� �� %a�fqa�c <br /> ELECTRICAL CONTRACTOR ci' C v r � r, � i o,Y�,O <br /> ELFC. CONTRACTOR'S MAILING ADDRE�� �Y�� !/��%`^�� S�� S��" �p�Lr-ro�i� /e�c: <br /> LICENSE N0. ��'/'C o � /7� h/L' EXFIRA,Tit�N DATE � ��� ��� �� <br /> ADMINISTRATCR �a� � r(� � !��y� � PHONE N0. � �'� ��3-� <br /> �� <br /> VALUE OF WORK (;c nct incluoe taxes) <br /> (for commercia work <br /> USE �P BUILDING / — ;��,h'+ . // �S. <br /> �OTE: WAC 296-46-140 requires that plans Tor electrical work at educational, <br /> institutional or health care facilities be approved by the State of <br /> Washington. Applicants with such jobs �;.ust show the State-approvetl plans <br /> before a City of Everett permit will be issued. <br /> 'NORK TO BE DON_: <br /> - /,v��2 ��f�� / 1 A�-r I�'c�; ; �ij <br /> �Cd�1 � X !t s� � /n s��+�� !t Pt� �C�� /r��yo <br /> ����� c/s^rrcG� 1 t=��- �� F� <br /> � <br /> SICNED : _ ��i' �f�/ ���f DATE "' %. ' � <br /> NOTES AND COMMENTS: �_ <br />
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