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12505 21ST AVE SE 2016-01-01 MF Import
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12505 21ST AVE SE 2016-01-01 MF Import
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Last modified
4/10/2017 9:59:22 PM
Creation date
4/2/2017 4:02:30 PM
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Address Document
Street Name
21ST AVE SE
Street Number
12505
Imported From Microfiche
Yes
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ELECTRICAL PERMIT APPLICATiON <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR SrREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org / <br />���� ` �� <br />� <br />�: ��a�-���1 <br />f Zsos 7� �t- A-�C sE �� r�cl� ���� <br />PROJECT ADURESS <br />Owner <br />Tenant <br />Eledncal Co�!ractor <br />Mail Address <br />Mail Address <br />Mail Address <br />EC AL(��Lf���-f� <br />Slate License Number (required) <br />�� <br />Proposed Use of Building <br />Square Footage (If residential new cons�ruction, remodel or addilion) <br />NumUer of devices Q( low voltage) <br />City <br />City <br />City <br />Slate/Zip <br />State/Z�p <br />State/Zip <br />Phone <br />Ph�ne <br />Phone <br />aPP<<ed �-- 5�z7�1 s <br />City of�Evereri Business Lic�N mber (required) <br />"( Lf/—GC/ <br />Contract Price of Work <br />VYI l .rJAL�tit 7�6= 7Zs�- ���X <br />Contact Person/Contact NumbedEmail <br />Descriplion o( Work to Be Done: _.��y��ff� %iLGU� F'Gc�� ['r�-- (%!-'I! <br />CITY OF EVERETT LOCAL SALES TAX CODE IS �105 <br />I hemby ce�tiJy that f have read and examined fhis applicafion and know fhe same !o be (n�e and <br />co�recf. All p�ovisions ollaws and ordinances goveming fhis type ol work will Ge completed <br />wheUrer speci�ed heiein or noL The granting ol a pennit does not presume to givc authonty to <br />violate or cancel the provisions ol any other sta�e oNocal lavi regulafing conSWcfion or fhe <br />pedomiance o/ construc(ion. Thaf I am authonzed by the ownerol (his property lo pedomi the <br />�a�ork /or which application is made and I wmply wilh the State Con(ractors Law 18.27 RCW and <br />296.200 VVAC. � <br />S•2�-Zd�� <br />IieV15[OOHNY.'014 <br />FEE <br />500° <br />P�RMITit <br />E15 �S-l`.� <br />
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