|
�— -ELECTRICAL PERMIT APPLICATION
<br /> 1.1111,1
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT, WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps©everettwa.gov I www.everettwa,gov/permits
<br /> ''i{{i�lu jl�Sls fti���,''t'Gr rISIr'IY:,1i41i r�441,,:�1j41r�,,rry,�`���lii 1w�41rlr I).4��:lk;}'7`;' ;„"}S. ..b. i+•�
<br /> 1 �•• �,�- C"d ,1",,r:l.l' 9 S::lU.11r 1 f:t S�.f p.—}ia�.;� 1 c t l r]I�V r' i y 'rI°'f.;fjit ` I t,1. ei:e •�'�
<br /> '. "11 .,.. $. 4.''yyl��y{{yy,,�� ,I yyyy yy y1��rak�.��I��'4"i��i�4,1'r 131��Jd�{�$ S?�ll� ���}4���-1��S�MdY�A'lii�t��l{���fl� ���l f
<br /> .. . I i�;''�; r v �,. .AfrV,f!,���A'��.� ��i1!1 ,� T'' � �.4 �;1,�j,�1� rlil#k� ,P (}rp }Ill Il�i�' .4�r�i
<br /> S1 ��siv�i lt,nx ,lri' v,r�, ,wr„ S 4 sI,Ru l�i ,S lu:' its ,6.0 db�T��t..,;'l��Yvn 11„
<br /> PROJECT ADDRESS: � V Q 0 41/ S T
<br /> BUILDING AREA(if residential,new construction,remodel,or eddltIon)_)O t� SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED D DUPLEX 0 MULTI-FAMILY-#OF UNITS; TCOMMERCIAL
<br /> USE OF BUILDING: ..iZ C OP-lb-S.'
<br /> -
<br /> :, i} •Al S PtH, qi l '. eg $, M,4tr: 0i411MNPWAMh$ 9YII
<br /> R ,
<br /> CONTRACT PRICE OF WORK:$ r ( )0
<br /> NUMBER OF DEVICES(if low voltage): a ‘ —.^
<br /> FIRE ALARM? ID YES 'ANO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable);
<br /> DESCRIPTION OF WORK:
<br /> e ' g !? a,.) S-` 4 eF70 v(? 14_
<br /> - ,__n.. .._..— • r y 041
<br /> 1
<br /> 0 ?•d1SySIla.: � `�idia.r•f'i.4f)'i4;ta;'uli',ii'l•i:.,.,:r•"ki��';[1':r:l;,a.'',V'Ynl,da��„i:�rl;�.'•1 1.�,,W,u` reo01i , l MgA, y�'{SiWm.lk.i.S,9i:;,�y`it���;N,ne:ri iIt„,r•L'.tct:i$.,,ii.5aG.a1 rliu t k:•,:";.,i.v;k'!RAdntrr(n�;'.I',1,.,:�t i�i"Ia'rP',�t
<br /> Nii�
<br /> N
<br /> OWNER NAME: �-ve ���I,) .i� TENANT NAME If Com /7- �
<br /> !/tit 2
<br /> OWNER MAILING ADDRESS: sTraeer t'l 0 1
<br /> ,
<br /> CITY sp@A — — STATE •w 21P !�Z I
<br /> OWNER PHONE.2S� c7
<br /> 3 I 64-2._ IOWNER EMAIL:
<br /> CONTRACTOR NAME: L Rb y,�A.1 Uig�'�L•
<br /> sem - � ,_ �.6 ��`"'"" �J/
<br /> CONTRACTOR ADDRESS; STREET ( .13,t t Sr /Y/
<br /> _ CITY ��r'f l / e- STATE U'A ZIP Te ti 3
<br /> CONTRACTOR PHONE: Xi(, el , F.- 526 Z.- (CONTRACTOR EMAIL: r e_ r w p; 4-r-Sagat e,ley 1
<br /> CONTRACTOR LIC.#REQUIRED): 1)A- Z? 1( CITY OF EVERETT BUSINESS LIC.#(REQUIRE (
<br /> t7
<br /> PRIMARY CONTACT; 0 OWNER„CONTRACTOR D OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: .2 D , , 6 T•
<br /> CCONTACT EMAIL: ok eo I/ 4 Uq-2p ScaliirFs,lam',
<br /> A(3REEM�NT,'T hereby certify that I have reed end examined this Application and know the same to be true end coma, All provisions of laws an
<br /> type of work will be completed Whether speciftod herein or not. The granting of a permit p ovisions of any other this
<br /> focal raw rivulet! cosCt0e5 not presume to give authority to violate or oanCa/the prnvlsloaa any other state or
<br /> g Construction or the performance of construction, That I em authorized by the owner of this property to perfoml the work for which eppl+'Cation Is made and I
<br /> Comply with the °tate Contractors Law 15,27 RCW and 296.200 WAC,
<br /> City of Everett official Use Only
<br /> ii (
<br /> FEE
<br /> .--
<br /> PERMIT#1
<br /> AMPA , _. E 5 t [ - / ( 3
<br /> 0 d 'gent Signature
<br /> Date (Revised 10/12/2018)
<br />
|