Laserfiche WebLink
LECTRICAL PERMIT Al LIGATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98209 <br /> (P)425-257-8890 FAX 425-257-8857 1 (E)everefiteps@everettwa.gov) www.everettwa.gov/permits <br /> PROJECT SITE,INE.®RIVIATIAN <br /> PROJECT ADDRESS: J�iy` 1/U! LA <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: J COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMAT10N <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: e / t�� 2_ ex Gc <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> C[Ty STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: sTREu a <br /> CITY Wo 0 STATE (N } 'P/� <br /> CONTRACTOR PHONE: _ 0-7z-o CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): LVH 1/t L- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): O o� <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: j� CONTACT PHONE: <br /> CONTACT EMAIL: t,6C <br /> AGREEMENT.-Thereby certify th t/have read and examined this application and know the same to be true and correM 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 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 1 <br /> comply with the State Contractors law 98.27 RCW and 296 200 WAC <br /> City of Everett Official Use Only <br /> FEE <br /> PERMI # <br /> F <br /> Owner/Autho izedAgentSignature Date (Revised 90/92/2015) <br />