Laserfiche WebLink
' �ECTRICaL PERMIT AP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES ��6��`I�� I <br /> 3200 CEDAR STREET, EVERETT. WA 98201 I �-� `-I10 <br /> (P)425-257-E810 � FAX 425-257-8857 � (E)everetteps@everettwa gov � www everettwa gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECTADDRESS: p�III ,� ��Yt�So�n � CPIG.�t, <br /> BUILOING AREA(rf resiCeoual, nr•w co:�;lrucuon, remodel,or addmon) SF <br /> BUILDING TYPE: FR-DETACHED ❑SFR-i1TTACHED ❑ DUPLEX ❑h1ULTl-FAMIIY-#OF UNITS. �COMMERClAL <br /> USE OF BUILDING. <br /> ELECTRICAL APPLICA1f10N INFORMATION <br /> CONTRACT PRICE OF WORK: 5 0�,a$<j.-7 O <br /> NUMBER OF DEVICES (d iow voltage): <br /> FIRE ALARM? �YES NQ <br /> ASSOCIATED BUILDING PERMI7# if a licable � <br /> DESCRIPTION OF WORK: � �nc� x��. �i� . ���cltis_b ois�-la tr �`n'-�'S l� C�a <br /> �ac.� CYiS4�� Sr� �'u �Sls <br /> CONTACT INFORMA'dION <br /> OWNER NAME: � �1A G(' TENP.NT NAME If Commercial): <br /> OWNERMAILINGADDRESS: sraecr �III �C�QY� � C (+�r <br /> cm LVfR'C�- StFrc �� ��= 9Saa� <br /> 01NNER PHONE: N��d' OWNER EMAII.: %�f'/� <br /> CONTRACTOR NAME: ,ot �Ti M!� � (C��L- Ir��- <br /> C9NTRACTORADDRESS: srw[t� yv � <br /> �,,.- 1�.,.��a ;,�,F wa r.�. �syq <br /> CONTRACTOR PHONE: �j� �� �j��l� CONTRACTOR EMAIL: CJehb � OI�y��r��C C ICC.-I-nC. � Cp�1� <br /> CONTRACTOR LIC.#(R[OUiHED�: OL D�I E I O a. 1 L 6 GTY OF EVEREIT BUSINESS LIC.p�REQUiR[O�: <br /> PRIkARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Speaty) <br /> CONT�AC7�,N�A�ME: 1, CONTACT PHONE: �S3 (��7 3(�1 <br /> i�C{�bu,'S�C'D" CONTACTEMAIL: C�Cbtl ��c�--�—lY�,�� �GC,-�1,1L , CA <br /> AGREEMENT 70ereDy ce�hly fha!1 have mad an0 e+u��meC t5is appl:cahon an01 now IAe same lo be frue an correct All pmv�sions o�laws and ortlinances govemin9l��s <br /> rype o�uork wi�l be tomplefed wAetliei specrled herem ar nol Tne 9ranfrng ol a prrtnd doea no(pmsumrlo give aul�nnry fo v�olafe or cancel fhe pmvrsions o1 ony ot�er slale cr <br /> lxa�law rcgul,ihng ronsfrucnon o�lhe peAormance ol ronstroc0on Tnal I am au!honre0 by Te o�.rner ol fArs pmpeM����'Horm fAe work!or u�A¢n app!.r.almn rs maCe antl/ <br /> mmpy u��l�Me Sfa'e Cwmlydcfor..La�v 18 27 RCW an0:96?OO WAC <br /> Ciry o/Everett 09ina1 Usc Onry <br /> FEE <br /> I 6�� °�' <br /> PERMIT# <br /> 1- 4- I E� � ��� - U�� <br /> OwnedAu�horized A t Signature Da;e (Re�vsad 70�f7G015) <br />