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5120 BEAUMONT DR 2016-01-01 MF Import
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5120 BEAUMONT DR 2016-01-01 MF Import
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Last modified
3/6/2017 2:18:35 PM
Creation date
3/6/2017 2:18:33 PM
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Template:
Address Document
Street Name
BEAUMONT DR
Street Number
5120
Imported From Microfiche
Yes
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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES � ����� <br /> 3200 CEDAR STREET, EVER[TT, WA 98201 <br /> 425-257-8810 - FAX425•257-8857 –www.evereltwa.org �1/��"0�3 <br /> APPLICATIONS AR[ACCEPTED FROM 8 AM TO 4 PM <br /> ,5!�� -�-�-`�ll ��-��— �c°i <br /> PROJECT ADDRESS <br /> . I 6v�, S� ✓ . �xao Lss 1 � <br /> Owner MailAddress Gty Slale/Zip fhone <br /> TBnant Mail Address Cily Slele/Zip Phone <br /> I � }- Uas <br /> V�. - nUl r �{(_ 1 ' �G .-1�Y�C� I,1j�� J L�� � N� /�'`A/ ISvtIIPi V4- <br /> Elect� I ODlfaclo� MaitAddress Ciry le/Z!p Phone <br /> 1�.���-�V �T G s��—^ <br /> Stale License Number Contra:l Prico of Work <br /> Praposed Uee af Bullding Conlacl Person (Plan Review) <br /> Description f Work to Oo Done: �."IG V �v J�� ���u� ��� <br /> c n�__Z- �-I� <br /> NOTE: WIRING IN NON•DWELLINGS IS RE�UIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> _ a <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> 1 hereby certily fhaf!have read and exemined this applica(ion and knorv Ihe same fo ho fruo and <br /> correcf All prov;slons ollahs and ordinances govemmg fhis fype ol woric will be cemplated <br /> whafhei speci/led ho�ein or nof. The granlinD ol a pormit does nof presumo fo glve:�ufhonfy fo <br /> viclate or cancel fhe provisions o/any ofher sfate orlocal law regulefing constvction or tho <br /> pedormance o/consfn�cflen. Thaf 1 am aufhonzed 6y the owner ol(hfs prope�ty to pedorm fho � <br /> work Ior which applicafion!s mn corrlply wilh fhe Stale Confracfors Law 18.27 RCW&nd <br /> 296.2�0 . 3 <br /> _ � ( r � I p� D <br /> l <br /> Si nalure , Date <br />
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