Laserfiche WebLink
477 LECTRICAL PERMIT A 'LICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> rrP__ROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 14o 7. UO• I 5-a...) �V'`2 vett SLY- q ZLT j - '12.tk•I • I <br /> BUILDING AREA(if residential, new construction, remodel, or addition) __SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: LJ /€ ) /A•1� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $1J 2-(0 O ._--- <br /> NUMBER OF DEVICES (if low voltage): 3 <br /> ��// <br /> FIRE ALARM? 0 YES ,fNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: (r /2.',1-01.le if- /eI-ee / eel '-/LU?lL ��:;rk /e p�zyc_ 4*u vd f—r�.p <br /> C{ C' .�'i rc 3�1. , ( W;-e <br /> / /1 CONTACT INFORMATION <br /> OWNER NAME: �-6'k 1(63 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET i .I e014._ l F ��ZZ <br /> CITY � ,� STATE 4' ZIP /til <br /> OWNER PHONE: OWNER EMAIL: ,�^^ <br /> CONTRACTOR NAME: Mr r€ c ti/IL O :L <br /> CONTRACTOR ADDRESS: STREET�.�/ /Ce')/S - 36, /(.(C� 4 it) ( <br /> E <br /> ��ay -` CITY 1./ Lei/444 � 1/1 C-v STATE 0J4C� <br /> - ZIP / TC <br /> CONTRACTOR PHONE: /1-2-s—_-7 74— c DZ CONTRACTOR EMAIL: are( c.(jri /U/`'6c /S-e4:-(f- �4Cu4.1/ Com` <br /> CONTRACTOR LIC.#(REQUIRED): M L t C I e O (y CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (U'/S <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: Lr-Zs 7.7 -7 o <br /> L Ctv / <br /> Kc,4 c CONTACT EMAIL: )p^ � <br /> `� I r' t C_ yC <br /> ek y � S esk, fit : <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type <br /> of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> - <br /> PERMIT# <br /> r ark. Et i-o <br /> Owner/Authoriz,. Age it,ignat e Date (Revised 9/23/2016) <br />