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#0411,,.-.-- ELECTRICAL PERMIT APOLICATION <br /> . <br /> I�►� . 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 1 viww.everettwagovipermits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: t Ca. .,,..- V Y-.1 V <br /> BUILDING AREA(If residential,new construction,remodel,Or addition) m SF <br /> BUILDING TYPE; C3 SFR-DETACHED 0 ATTACHED 0 DUPLEX 0 MULTI-FAMILY-II OF UNITS. ' COMMERCIAL <br /> USE OF BUILDING 1 IA <br /> ELECTRICAL APPL CAT1ON INFORMATION <br /> CONTRACT PRICE OF WORK: <br /> NUMBER OF DEVICES if Dow valla t- : 1)#* <br /> FIRE ALARM? 0 YES s NO <br /> -ASSOCIATED II-DING PERMIT#11'applicable): <br /> DESCRIPTION OF WORK: 'TALL =. L V,,,,, ''I - ,- €g. -{ ' : .":. <br /> CONTACT INFORMATION <br /> SER NAME: e---t rtr. C `` g' TENANT NAME(If Commorclai}: bI 1 ' ,, V°f ( <br /> OWNER MAILING ADDRESS: STREET '2 14 '? 3 'r IL <br /> carr lie5 srnn. ( k-A DP i C t <br /> OWNER PHONE: DOWNER NEL: <br /> CONTRACTOR NAME: , - ,t <br /> CONTRACTOR ADDRESS: STREET t .. 6 1 T“ . <br /> CITY STATE Vr� ZIP <br /> CONT TOR PHONE:20 a:6 . ' CONTRACTOR EMAIL; t 1 (, ,.0?'"1,4 (4 ."FID,--4,4 .., Pe, ' <br /> CONTRACTOR LIC,#(hlEDuIREt3): -, tc ib I Al Silk cr v OF EYERIETT BUSINESS LIC: FEOuttREO: 05 11 it <br /> PRIMARY CONTACT: 0 OWNER ., CONTRACTOR C)OTHER(Please SSI „mm „.. <br /> CONTACT NAME: CONTACT PHONE: '. <br /> totti '44* CONTACT TAIL: <br /> ACS T T hereby codify that shave read twat;wombed that application sad know the sem*to be true and'comsat. Ali provisions of and ordinances governing this <br /> type of work wvie be bonen omit The granting of perm"does not preswna to give authority to violate orcense/the provisions of any other state or <br /> local taw regulating constatotion anise pentormence orconstruction, Theft am eseaortsed#ay the*emir or this to nedtionztre aadek fanWis h f£ppifcar is mad,arae+r <br /> comply wet the State Contractors Law 1827 Rcwand 29E200 WAC, <br /> City of Everett Official Use Only <br /> FEE <br /> -, \ Woo i 0 <br /> i , : 1 i#iPERMIT it <br /> } 'if <br /> 2. 'Sock - CO <br /> ,. " <br /> Date (Revised 11/12/2015) <br />