Laserfiche WebLink
ELECTRICAL PERNIPAPPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> OL 8200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-2557-8887 ] (E)everefteps@everattwa.gov] www.everetMa.gov/parmb <br /> li<�1�1�'8'' IIIaR$RMAi'Ir'dQII� , <br /> PROJECT ADDRHS9: (.� 1 h �. C i�` Z1 t l <br /> BUILDING AREA(if residential,new construction,remodel,or addition) gp <br /> DUS <br /> 'ILDING TYPE: SFR••DETACHED QSFR-ATTACHED QDUPLEX Q MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> E OF BUILDING: <br /> E�.E `Ttli41L1lI"�lp( `�'lfiOl l�11ORM�TIQI{+1 ; <br /> CONTRACT PRICE OF WORK.$ 0 C , <br /> NUMBER OF DEVICES (if low voltage): /V/4 <br /> FIRE ALARM? Q YESQ ,C6 <br /> ASSOCIATED BUILDING PERMIT# if ail Ilcabie : r1v1 e(k�zY��i e ��I<m }j-g"vnc:f-+(e( Air- D,44y <br /> C� � <br /> DESCRIPTION OF WORK: <br /> v V,6t- C t In iod: <br /> QwN>Wi#NAIw@..- � • Ilr't. - .TENANT .. . .. . . ._• ,. .. .•�. ,:,. <br /> NAME If Commercial: 54- IA 4,o <br /> OWNER MAILING ADDRESS: <br /> r CnY V��'� •�. ,. STATE �'�-'� Z!P <br /> O1flfNER PHONE: �z"_�, <br /> 2- OWNER EMAIL: <br /> CONTRACTOR NAME: � � �. :�t f ��• �'��c'. <br /> CONTRACTOR ADDRESS: MMT <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: °�� " a <br /> f I � sAA <br /> CONTRACTOR UC. REt�UIRED}: �, 'c F f' CITE''OF EVERETT"BUSINESS UC.#(REQUIRED): ,7`J <br /> PRIMARY CONTACT: Q OWNER O CONTRACTOR OTHER(Please Specify) tY Dtt C r <br /> CONTACT NAME: coNT'AC t PHONE: <br /> CONTACT EMAIL: Off!6 r� �� ,�. �a ,� <br /> A�REE;MENT.•7 hereby certify that 1 have read and examined this appllcS60n end know the same to be true and correct. At/provisions of laws and otdkwnees govemtng this <br /> type of work wilt be completed whetherspeclfled herafn ornot. The grantlrg of a permit does not presume to&,a autho*to violate or cancel the pmv/sions of any other state or <br /> local law regulating construction or the performance of cons6uction. That l am authorized by the owner of this property to perform <br /> complythe work for whfch applicaflan is made and l <br /> with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everatf Of iolef Use Only <br /> FEE <br /> *-1-(�5, <br /> PERMIT* <br /> �41 3 <br /> 0 r thorized Agent Signature Data (Revised 10/1212016) <br />