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4702 FOREST DR 2016-01-01 MF Import
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4702 FOREST DR 2016-01-01 MF Import
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Last modified
2/11/2017 9:57:50 AM
Creation date
2/11/2017 9:57:41 AM
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Template:
Address Document
Street Name
FOREST DR
Street Number
4702
Imported From Microfiche
Yes
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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM <br /> y� �2 ��-,�� ��1 �c F �.� e � e ��. � ��L �'�3 <br /> PROJECTADDRESS � <br /> �I� - o , �i7� ,1 I� y-�1 ��2 �-�� i r >t 1��— ����c ��\ \ti?�{� �l� 2��3 <br /> Owfief Mail Adtlre:a City Sta�elZip Phme <br /> �-} ZS 33q ��� � <br /> Tenanl MailAddress CRy StatelZip Phane <br /> Q t�i l�E�2 <br /> ElecUical Contractor Mail Address Ciry StatelLp Phane <br /> Slate License Number Contract Price of Work <br /> Proposed Use ot Building Conlact Person (Plan Review) <br /> Descriplion of Work to Be Done: NlOy� �L1=GYQICi N E'�. � T O ��OA1 r O� <br /> He„sE ,ar��ox. 5is rr FAsr - � ro a� NoRTF� w�r� z�� ELEC'I'R.lGAAI. <br /> NOTE: WIRING IN NON-DWELI_INGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3705 <br /> 1 here6y cerlify(hat 1 have read and examined(his apF(icafion and know the same to be fnie t.:id \ <br /> correct. All p�vvisions ot laws and ortlinances goveming this type o/work will be completed �\ <br /> whelher spec�ed herein or noL The granfing ol a permrt does not presume to give authonty fo \ <br /> viola(e or cancel 1he provisions ol any ulher sfafe or bcal law�ogulating construc(an or the <br /> pertormance o(c�onstruction. That I am authorized by the owner ol(h,is property�o paAomi fhe ^ � <br /> work lor which app/ication is made and 1 cnmply wdh fhe Stale Contrecrors Law 1827 RCW and t }\ <br /> 296-200 WAC. O ) <br /> � � ✓ <br /> ���\ \ �ti � �� yv� a � � � -)�1 „ ,�[// <br /> SignaWre ate / �/ 1 <br /> %\.J <br />
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