Laserfiche WebLink
(P) 425-257-8810 <br />�ECTRICAL PERMIT AP�.ICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: /� Q � j%% �'n2 V i G� I✓�L 4 W Q 2.d <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL <br />USEOFBUILDING: j/yQ,f��Cy��-� me <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: Ize. �� j i yL+ �{ <br />�le�� �� ' a �' Ip � " .. �- � 1( <br />� o w e �2 ; <br />CONTACT INFORMATION <br />OWNER NAME: u TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srREEr I'Y%p n►h,L ,� � � <br />CITY I��G I I STATE W� ZIP �(,J <br />OWNER PHONE: ,3 �' `' �f ' U3 T OWNER EMAIL: �{'r- � � �( • Oyyi <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: srREEr <br />CITY STATE ZIP <br />CONTRACTOR PHONE CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAIL: <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 const�uction or the performance of construction. That / am authorized by the owner of this property to perform the work for which application is made and 1 <br />comp/y with the State Contractors Law 18.27 RCW and 296.200 WAC. <br />uthorized Agent Signatur'e Date <br />City of Everett Official Use Only <br />FEE <br />��c�� <br />� <br />PERMIT # <br />E ��II- I2 <br />(Revised 10/12/2015) <br />