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10921 19TH AVE SE 2016-01-01 MF Import
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10921 19TH AVE SE 2016-01-01 MF Import
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Last modified
5/22/2017 12:21:10 PM
Creation date
4/2/2017 11:00:49 AM
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Template:
Address Document
Street Name
19TH AVE SE
Street Number
10921
Imported From Microfiche
Yes
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ELECTRICAL PERMIT APPLICATI�)N <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320D CEDAR STREET, EVERETT, WA°8201 <br /> 42�-257-8810 - FAX 425257-8857—tivww.everettwa.org /� �a��-�( <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO A PM C I�I Z- "�ZZ <br /> ���02� � ` �/�S-P. �- � • <br /> PROJECT ADDRESS <br /> i <br /> r l-��„o,� �� C s:�� <br /> Owflef Mail Address ��� City StateJZ�p Phono I <br /> -� so�J ' S1atiu � �ur.�f bAJa . f,Fao� <br /> Tenant Mait nddress �— ciry State7Z�p Fhone <br /> 5b 3 - <br /> �21�1<�n�f ���,"n � • y3S" �• E. l�afucoc:l /D�;lc�++� (�r. fj'7a�1 � Fr . - <br /> Electrical Contrador Mail Address City StatclZp Phone a �7 <br /> hn r.� 5faf� �1.�'� G � �I� • GtJ <br /> State License Number Contract Price of Work <br /> �i �S _��-�o-/�v ,� rso.�J��c Szs�i-lv a 9�3s �i� <br /> Propos d Use oi Building Cc�tact Person (Plan Review) <br /> ,,� / / ,} �' <br /> Descriplion of Work to Be Done: /`f'� �f`�� / .4�1 G� ���k �� /t � U � / <br /> INOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> � BE IN RACEWAYS, MC OR AC CABLE. <br /> I CITY OF EVEREff LOC ES TtiX CODE IS 3705 <br /> I hereby ceRrly tha!!ha e read and amined this applicafion and kncw fhe same to be true and ��) � rL ' �2 Z <br /> correct All piovisions flaws and or ances govemin�this fype of work will be complete!i <br /> whetherspea5ed nerci or not. The g ntlng of a permrt does not presume lo give aufhority to <br /> violate or cancel(he pr visions ol any ther state or loce!law regulating construdion or fhe <br /> pedomrance of consl dion. Thot 1 a authorized by the owner o(fhis property to pedorm fhe <br /> work 1or which applica on is made a d!comp with fhe S7ate Contracfors Law 1827 RCW and <br /> 296.200 WAC. <br /> /d - 1U - ( / <br /> Signaturn fla'e <br /> q'd LLL9-bL9-609 �I�ef' 1�eq°a e0l L0 l l OZ ��0 <br />
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