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10011 12TH DR SE 2016-01-01 MF Import
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10011 12TH DR SE 2016-01-01 MF Import
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Last modified
4/4/2017 8:50:23 AM
Creation date
4/4/2017 8:50:14 AM
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Template:
Address Document
Street Name
12TH DR SE
Street Number
10011
Imported From Microfiche
Yes
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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVdC�S <br /> 3200 C[DAR STREET, EVERETT, WA 98201 <br /> 42�257-8810 - FAX 425-257-8857—www-everettwa.org <br /> �--3 -/z <br /> pPPLICATIpN5 ARE ACCEPTED FROM 8 AM TQ 4 PM <br /> CC/�u -o�� <br /> 1Do� l ►�I,�� n� � � ��.e� ��.����.����a�w�� <br /> PROJEC7 ADDRESS <br /> I,�m���.� 12�1�C1��►/I–�—�� �ti���� 2� � � u <br /> Ovmer M.iilAdQra�s GAY StaIdZIP Phone <br /> tJ <br /> ___..� I`�J <br /> T6nant MailAddress City StatulLp P�one <br /> ������ ' �� U �2�'�G'�1�r�7e�� �f--�,Y;�l'rr���w,�1�� P,�D22 �Ga �r����,�6` <br /> E ecUica��;ontmctor Moil Addreso CHy StatelL�p Phonc <br /> p�ec%�e��l�yL,�� 2�0, � <br /> Sta W. cense Number Gontrad Price of wonc <br /> � 1 rl�Fl � ,� <br /> h I�II S (/{1JVI <br /> Propo d Usa of Buil g Contact Person (hla ewew) <br /> Descriplion of Work to Be Done: D�� <br /> NOT[: WIRING IN NON-DWELLINGS IS REQUIRED TO �E <br /> BE IN RACcINAYS, MC OR AC CAl3LE. ���,+� <br /> CITY OF EVERETT LOCaL SALES TAX CODE IS 3705 <br /> 1 he�eby certi�y t�q�1 have road and examined this appllce�fion and know t7ie same to De true and � 1� %\� J r �l j <br /> correc[ A/l p!ovi�rons of laws and orrlinonces govemin,q fMs typa o��vork will be comp/eted � U L j IJ�G <br /> whother specrfied herein or not. 7ne gront�np o!e permit tices not p�esume to glve aufAo�lty to <br /> violdteoiconcefthe Provisionsofanyofherststoorlocallawregul�tingcaistrucLonorthe <br /> peAortttance oi constn�c(ion. rnot f am camorizod Dy tne owner o/thrsp rnprlrty ro pe��fhe <br /> work fa which applir,t�t is made and 1 comply witN the State Contrac[ors La�v 1817 RCW and <br /> 2 00 WAC, <br /> � ' v <br /> Slpnature ° <br />
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