Laserfiche WebLink
LECTRICAL PERMIT JWLICATION <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 Www.everettwa.gov/permits <br /> rkdJECT SI'PE 9NlEORIV1Ai'1®P� <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> ,BUILDINGTYPE: ❑SFR-DETACHED ❑SFR ATTACHED ❑ DUPLEX L7 MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL A��LB,CA ITI®N INFORMATION <br /> CONTRACT PRICE OF WORK:$ o <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT# if applicable}: <br /> DESCRIPTION OF WORK: <br /> - COIi�TAC'1' I.I�IFORMATION <br /> OWNER NAME, - : �� (Ira ? . NT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREEr <br /> CITE' STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE '" ZIP tJo� <br /> CONTRACTOR PHONE: CONTRACTOR <br /> ONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIR D): lS1rl�17 CITY OF EVERETT BUSINESS LIC.#(REQUIRED).60''31 <br /> PRIMARY CONTACT:w ER ❑CONTRACTOR OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: — <br /> a CONTACT EMAIL: <br /> AGREEMENT. Thereby certify that I have read and examined this application and know the same to be true and correct. Alt provisions of laws and ordinances governing this <br /> type of work will be completed whether specNed herein or not The granUng 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/ <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> Owner/Auth rized Agent Signature Date (Revised 10/1212015) <br /> 1. <br />