Laserfiche WebLink
-LECTRICAL PER ,111T UOCA ION <br /> /041vP"'.1- ;it.: <br /> vil <br /> -, , , _ CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br />_ (P)425-257-8810 ] FAX 425-257-8857 ] (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ` _ <br /> I <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF I <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 1 ULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL 1 <br /> USE OF BUILDING: 1 ` <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ C> -) <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES N.1110 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): 11 <br /> DESCRIPTION OF WORK: 'V ``,U 1 'L` ' N ¢ - , i ` __L _ \L)� =c\--- <=-`va L�,1. (_.k <br /> CONTACT:INFORMATION <br /> OWNER NAME:Cokt -tpmka,K=Ic-„AA TENANT NAME`,(If Commercial): <br /> OWNER MAILING ADDRESS: sTREEr (.f. .fl) yc-�� L, �j W <br /> CITY �,'l0\)� Q <br /> ej � r STATE -4 ZIP co L, <br /> OWNER PHONE: - vZ` 131/ OWNER EMAIL: tom► ,._, _ . .: . .,..... ... .,. ., <br /> CONTRACTOR NAME: UVJ. \ LC__ ` /{ <br /> CONTRACTOR ADDRESS: SIRE k 'v �Jl� L‘/42/ <br /> CITY - V2 \ STATE ZIP qZ <br /> CONTRACTOR PHONE:gz`))Z(Q•—`7 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED)•,'. NR,L (,L CK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Ubk_. <br /> PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:. r2? O r <br /> l`,`1 <br /> ( & cL\/' . CONTACT EMAIL: �0 -�� 1 (�: i� <br /> AGREEMENT:T hereby cMiy that 1 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 ornoL 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 I 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 /> FEE <br /> tll 5D <br /> PERMIT# <br /> /'. <br /> ��� _ rU � � 1"))- <br /> •caner/Author 4-"°•7-gent Sig?ure Date (Revised 10/12/2015) <br />