Laserfiche WebLink
04/77- ELECTRICAL PERMIT APPLICATION <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@everettwagov I www.everettwa.gov/permits <br /> C. <br /> C) <br /> PROJECT SITE INFORMATION <br /> , - <br /> PROJECT ADDRESS: 4 0 0 \t"(..S-r 0 Ai, 1 1\40 1R,t) <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: RCOMMERCIAL <br /> USE OF BUILDING: Ok.,./C''e-- <br /> ELECTRICAL APPLICATION INFORMATION <br /> 11.11.1.••••••••••••••• •1011.1/1.610••••114 <br /> CONTRACT PRICE OF WORK: $ (2 FO„ e"C) <br /> 'NUMBER OF DEVICES(if low voltage): <br /> __ _ <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ) I(.2 OV'. 0 ' <br /> DESCRIPTION OF WORK: ,(720de 'V kjikr 2-/vs/41// 6ieeceel-4- c-F„? -s-t--;'Taal' <br /> ,IORINOMMIORPINNIIIIM011.0 <br /> CONTACT INFORMATION <br /> —......... <br /> OWNER NAME: TENANT NAME(If Comrnercial):AvtATioNTricie_ ecut Geri' <br /> OWNER MAILING ADDRESS: STREET <br /> CITY <br /> STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: Ain e.,,NcR (\) Ele,cit,-,GA-i CA n If-i-Pc c...4-ori ,..rivc... <br /> CONTRACTOR ADDRESS: STREET 1/33:C"*0 ..3 91. A <br /> CITY S3777t STATE a/99 ZIP <br /> CONTRACTOR PHONE:PHONE: ,000(Q ".".6 77-7,577 CONTRACTOR EMAIL: 6,1:.m..9,-/c)(2e.fe_,?, c4v.)oFics-r,CONTRACTOR LIC.LIC.#(REQUIRED): iic,KER(ECco,3 K F CITY OF EVERETT BUSINESS LIC.#(REQUI RED):053 /A <br /> PRIMARY CONTACT: 0 OWNER Dir CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: .206-6 7 7- 7....\- .4? <br /> I &Li_ RA‘torley CONTACT EMAIL: 4qt, /72,94/6fiere .141,,, 6,9...c-7:-(0e.-• .. <br /> AGREEMENT;T hereby certify that I have reed and examined this application and know the same to be true and correct. Ail 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 construction or the performance of construction. That!am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> City of Everett Official Use Only <br /> 1111101.1.1•111M0•11•111.11101 <br /> FEE <br /> \ 0 CIL CI <br /> --- <br /> PERMIT# <br /> Owner/Authorieent Si ture Date (Revised 10/12/2015) <br />