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4914 BLACK FOREST LN 2016-01-01 MF Import
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4914 BLACK FOREST LN 2016-01-01 MF Import
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Last modified
1/30/2017 7:18:17 AM
Creation date
1/30/2017 7:17:49 AM
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Address Document
Street Name
BLACK FOREST LN
Street Number
4914
Imported From Microfiche
Yes
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�_ . � <br /> ."� <br /> ,+ <br /> r„ kA ' <br /> ��� Y�\t <br /> p � -'-- <br /> � � #°� /�/ � <br /> ��� CITY OF EVERETT DATE: � — �L7 — �� <br /> o " — <br /> ElECTRICAL WIRING PERMIT APPLICATION �E: J' ' `'`y' <br /> �"� ���/� ' _ <br /> : � <br /> o��g .�a aooREss <br /> Q" n TENANT <br /> z>y PROPERTY OWNER « <br /> f+ <br /> r r+H <br /> gd� ELECIRICAL CONTftACTOR ����/�-�'� �! <br /> ��� LICEhSE N0. ( s��/ —�C�'�p��� AT ON DATE /a- �/-d Y <br /> ��� ADMINISTRATOR PHONE N0. � 7 .��� � <br /> VALUE OF WORK (do not include taxes) <br /> (for commercia work <br /> USE OF BUILDING � ��/,� � ti <br /> . <br /> NOTE: WAC 296-46-140 requir�s that plans for electrical work at educational, <br /> institutional or healtl- care facilities be approved by the State of <br /> Washington. Applicants with such jobs must show the State-approved plans <br /> before a City of Everett permit will be issued. <br /> �� WORK TO BE DONE: <br /> i <br /> j �� t� <br /> 0 <br /> I <br /> j �_ <br /> ' �� <br /> � <br /> � <br /> ' �. SIGNED : - DATE /�—�7—�� <br /> � <br /> � NOTES AND COMMENTS: <br /> i � <br /> � 3 � � <br /> '�::�...; �:Vk�`:5�� <br /> E�1��8� <br /> 1?2°H <br />
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