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4513 5TH DR SE 2016-01-01 MF Import
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4513 5TH DR SE 2016-01-01 MF Import
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Last modified
4/3/2017 10:47:54 AM
Creation date
4/3/2017 10:47:49 AM
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Address Document
Street Name
5TH DR SE
Street Number
4513
Imported From Microfiche
Yes
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■ <br /> 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 8 AM TO 4 PM - DEBIT& CREDIT CARDS ARE NOT ACCEPTEU <br /> � �� 6 �is 13 S' "Pr S � <br /> PROJECT ADDRESS <br /> 2 < � <br /> Owner Mail Address City State2ip Phone <br /> Tenanl Mail Address City StatelZip Phone <br /> �� 6�) <br /> e�ih Nl�,�� �� lec ��SzY Go:�c� r�,�er �co �..,.J (,v� � ��zy9 '� 3i• 75� 2 <br /> Eleclncal Conlractor Mail Addmss City Slate2ip Phone <br /> .l I �'1 Nt,( i ti lN Y <br /> State Licecise Number Contracl Price of Work <br /> � <br /> � c' s � �c.. � ( <br /> Proposed Use of dwldmg Contact Person (Plan Review) <br /> Description of Work lo pe Done: � e_�JJ �� ��C )i f l+� C <br /> NOTE: WIRING �^' ON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RHGcWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> !he�eby certily(hat I have read and examined(his application and kno�v the same to 6e tnie and <br /> correc(. All p�ovisions ollaws and ordinances govern�ng this type o/work will 6e cornp/eted <br /> whe(her spealied heprein or noL The�ranfing o7 a permR does not presume fo give authority fo <br /> pe�oer ance�of corufruo(ion��Tbal l arn a�ufhoazed by lhe/oW e oflh s�roperty to peAot methe <br /> work Ior�vhich application is made and I comp/y with the State Contractois Law 18.27 RCW and <br /> 296.200 WAC. � <br /> / // � _ <br /> � l� LZ �S <br /> Si9» u - i � Dale <br /> �"j(; — / -� / <br />
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