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4532 5TH DR SE 2016-01-01 MF Import
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4532 5TH DR SE 2016-01-01 MF Import
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Last modified
4/3/2017 10:53:11 AM
Creation date
4/3/2017 10:53:04 AM
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Address Document
Street Name
5TH DR SE
Street Number
4532
Imported From Microfiche
Yes
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� — �. <br /> �� <br /> . <br /> ELECTRiCAL PERMIT APPLICATION <br /> CITY OF EVERETT PfRMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-&857 - www,everethva.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM - DEBIT 8 CREDIT CARDS ARE NOT ACCEPTED <br /> % S S � 5 �� �� S�. L���� <br /> PROJECT pDDRESS <br /> �"� —� <br /> /�`-•�' � �i/'_.� ��''--�ZrsC� <br /> Owner Mail Address City� Stale2ip Phone <br /> Tenant Mail Address City State/Zip . Phone <br /> ��/?�//J� �" / � ����� .:�� <br /> ��„"� � ' ' '`-L�a" C� GG�. ��g7�� SP'^/',e�%r`. � •-r-r..�'r�Al_^ 7r'7Z <br />� Electrical ContracWr Maif Address City State2ip L�� `�� Phone <br /> / <br /> '�-Lv:.✓/i/F 9�� ,. //7 <br /> State License Number Contract Price of Work <br /> �.i�r_-�'-rr� i <br /> Proposed Use of B�ildiny Cantact Person (Pl�n Review) <br /> /// �� <br /> Description of Work io Be Done: � /-'—� �nr-��" ,�i U��'7.�r? ����c'�; <br /> � <br /> NOTE: WIRING IN NON-DWELLINGS IS REQUIRED TO FEE <br /> BE IN RACEWAYS, MC OR AC CABLE. <br /> CITY OF EVERETT LOCA�SALES TAX CODE IS 3105 <br /> I hereby certily that;have read and examined this application and know the same to be Vue and <br /> conect. All provisions o/(aws and ordinances goveming this type o(work will be comp/efetl <br /> wnefner speci6ed herein or not. 7he granting ol a permd dces not presume to give authoritp to <br /> violate or cancel the provisiens of any oth,er state or local law regulating construcGon or the � <br /> peAormance ol construct�on. That/am authorized by the owner of this property to peAorm the <br /> work for which application is made and I cemply with the State Contractors Law 1827 RCW and <br /> 296.200 W��. i <br /> i'- <br /> � L-��\�� l 'ZO • O J <br /> Signawre Date <br /> ,�d S�� �- 1� ' <br />
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