Laserfiche WebLink
LECIRQCAL PERMIT APJCAT ON. <br /> s,. h 1 T CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> IPI k OJIEC T SITE [I ILO,MATRON <br /> PROJECT ADDRESS: 76'OO tit ,V rt )L- 6Je4 P`1 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: *OMMERCIAL <br /> USE OF BUILDING: 1, © . ,. i,/ I /_ •I-+., <br /> ELECT''IICAL AP LICATIO Ili 'IF4 "'MATRON <br /> CONTRACT PRICE OF WORK:$ 6210o0 <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? ❑YES .14 0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable):20F'#.p !! /' � /I,, /r_� <br /> DESCRIPTION OF WORK: i4dck ( k2A� o (tVi`T � %`r ¢v( �a� n %ce 041t SS_ <br /> 14 cid 0) I0Ot- 3/ cul Kw omeJ /Zy,zo�'IV .eel Avt. AI ,' , -le1iO4. . <br /> hid (() aoo ao8 v /i oL,Lfef -(101` new /-220 n0.e11 . <br /> AfiQ4(4 Aemoi is, <br /> I <br /> CO' 'TACT INFORM—ATM I .. 4(4 <br /> OWNER NAME: /) 7 eSlJ tOo/ i 51r(C TENANT NAME(If Commercial): 6-fl r a O'r✓/ <br /> OWNER MAILING ADDRESS: STREET 919)/ S / 1 r t }L <br /> CI ,A ( � <br /> TY Jer STATE /�,./ ZIP 9�jj...2c 71 <br /> 'OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 60110 e ' (et4/:C. (" <br /> AI trazi;A . <br /> CONTRACTOR ADDRESS: STREET 1)00S. (2(o 9 <br /> CITY M D O AA- ,e./li/erA STATE 1,4)(,t ZIP 5W3 <br /> CONTRACTOR PHONE: (o 0^ ZJ —CIO?LI" CONTRACTOR EMAIL: _brad 120,W .t'e d. &1.7"7 y <br /> CONTRACTOR LIC.#(REQUIRED): q0 � CITY OF EVERETT BUSINESS LIC.#(REQUIRED):5fy!O <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: t ! <br /> CONTACT PHONE: ' - 4Q ...,e /-0...,e /-0;1(l 80,1,1‘e-r- CONTACT EMAIL: bil bel r7e'ed,cc,l-i'yf <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this <br /> type 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 l 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 /> FEE <br /> - t 9 0 e'°-------- <br /> PERMIT# <br /> .,/,,, 1 $20.9 E t4%02 -- 2,20 <br /> w r/Authoriz•dAg= tSignature (Revised 90/92/2095) <br />