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10025 19TH AVE SE LAKESIDE ENDODONTICS 2017-07-13
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10025 19TH AVE SE LAKESIDE ENDODONTICS 2017-07-13
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Last modified
7/13/2017 7:36:58 AM
Creation date
7/13/2017 7:36:55 AM
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Address Document
Street Name
19TH AVE SE
Street Number
10025
Tenant Name
LAKESIDE ENDODONTICS
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FROM :JMcRae ; FAX N0. :360B638079 , Noi�. 23 2�10 91:58PM P1 <br /> ��---. <br /> GA� A-y � �}�. "�- ��o av.� {� '8— <br /> �7�� ZZ?- o(o�L7 <br /> ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, V�/A 98201 �I � 'a.3—/D <br /> 425-257-8810 - FAX 425-257-8857—www.everetiwa.org �'/D!/�i�6 <br /> AFPLICATIONS ARE ACCEPTED FROi1A 8 AM TO 4 PM <br /> !DO �t�, u S 2c?z �'b���T <br /> PROJECT ADDRESS <br /> DQ S �u� �t'A.�ad� �n,..s�, ak Eu,�a�,��' t,l� �i�jt� <br /> Owner Mail Addre�s Cily Sq�p Phone <br /> L��S� � � ��ON�'1c5 l SA�+CMn4nww\ 1�Vtff�t.TT (J/� 't/t6� <br /> Tenant MailAddress city StatefZip Phone <br /> i�� 1s,1�5�1�1�,,.��- u7Z s �qo�+- st- �G�-4�I.�. u� Q��4� ('zo�)zza�a� <br /> EleelticaiCOn(roctor MailAddresS City Staleflip Phone <br /> 1�+ T2kSZa22Gl� 7500 r" — <br /> State Licanse Number � Contrad Price of Work <br /> �2�(�A� OF*r �-Q— �F��An1 ?�al _��s��S�_'� <br /> Proposed use oF F3uilding Contact Person (Plan Review) <br /> Desaiption of Work to�e Gone: LRV� Ja I f�ne2,_����T1d-�A � S Ol�t� W�r�A�G I <br /> NOTC: WIRING IN NON-DWEILINGS IS R[QUIRED 70 FEE <br /> BE IN RACEWAYS, MC OR AC CAEiLE. <br /> CITY OF EVERETT LOCAL SALES TAX CODE IS 3105 <br /> I heioby certify lhat 1 have read and examined this applicaHon and know the samo to be frue and �I � I I ' /Z� <br /> conect. All provisions o(laws and ordinanCes goveming this type ol work tivill Ge compl�ted <br /> wheU�erspocihdd herein orttot. Ti�e granting ol a pemuf does not presumE to give aufhodty(o <br /> violato o�cancel p�e provisions of any ofhers(ate orlocal law mgulating constroction or the <br /> peAormance n.tniction. That 1 am aufhanzed by tho otmer vf this property to peAorm tho <br /> work for whic pp6 Gon is made and I cnmply wifh tho SYate Contrecfors Lnw 18.27 RCW and <br /> z�c.zov wac. <br /> a3 O <br /> Signn ate <br />
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