Laserfiche WebLink
4577 ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 E (E)everetteps@everettwa.gov J www.everettwagov/perm its <br /> /� rrPROJECT SITE INFORMATION <br /> , <br /> i <br /> PROJECT ADDRESS: 35C OG Lout- s7.20 J <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED� 0 SFR-ATTACHED El DUPLEX 9 MULTI-FAMILY-#OF UNITS: _ 0 COMMERCIAL <br /> (. <br /> USE OF BUILDING: e 1 QCP.vI <br /> ELECTRICAL APPLICATION INFORMATION <br /> • <br /> CONTRACT PRICE OF WORK:$ I 0 00 <br /> n '� <br /> NUMBER OF DEVICES (if low voltage): I V O h-?/ <br /> FIRE ALARM? ❑YES 040 <br /> ASSOCIATED BUILDING PERMIT it(if applicable): <br /> DESCRIPTION OF WORK: <br /> • " •CONTACT INFORMATION <br /> OWNER NAME_: Goorry R AI��j TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 350.2 Rdc.kzifr� Ave <br /> CITY Evewt STATE (AM <br /> OWNER PHONE: ((�� DOWNER EMAIL: <br /> CONTRACTOR NAME: I°4�-+t �! IS �/J (-- <br /> CONTRACTOR ADDRESS: water PO & 5068 <br /> CITY TAAryl -)04.7/-e-rIAA A ZIP /85 <br /> CONTRACTOR PHONE: 360-'153— Pm CONTRACTOR EMAIL: 4 0.(.kAII/setoci wv fI• ((o! <br /> CONTRACTOR LIC.#(REQUIRED): �//4/d ` - / c i CITY OF EVERETT BUSINESS L .#(REQUtRErl8I1III!''/r��Ial((th <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: nCONTACT PHONE: 16,43—It j't— "I 5j q Lp <br /> ! 1 C <br /> 14/to/O► e CONTACT EMAIL: +IA.te W/rf 5 e(e C_ - /. (moo <br /> AGREEMENT.:T hereby certify that I have read and examined this application and know the same to Se true and correct All provisions A aws 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 glue 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! <br /> comply with the State Contractors Law 18.27 RCW and 298.200 WAC. V <br /> City of Everett Official Use Only <br /> FEE <br /> 1 00 4C2 <br /> PERMIT# <br /> E bol - <br /> 'gwner!Authorized Aunt Sign re i Dye (Revised 10/1212015) <br />