Laserfiche WebLink
ECTRICQL PERAMI QV LICATION <br /> CITY OF EVERETT PERMIT SE VICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE IINFORMATION <br /> PROJECT ADDRESS: L 3 Z G n W l <br /> BUILDING AREA(if residential, new construction, remodel,or addition) 0 SF <br /> BUILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APIPL(ICATIOIN INFORMATION <br /> CONTRACT PRICE OF WORK: $ <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: CJ QQ U ©G'e <br /> CONTACT:INFORMATION <br /> OWNER NAME: Feng rrrW TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET / ^ L rc <br /> CITYcrj�" STATE 7JP <br /> L <br /> OWNER PHONE: O ' 11// OWNER EMAIL: �2� �OV. C 0A A— <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE LIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> i <br /> e�� C t CONTACT EMAIL: r <br /> 2 vo, C v yxr- <br /> AGREEMENT,Thereby certify that I 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 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 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 98.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> / 7 /)/ <br /> PERMIT <br /> OwnedAuthorized Agent Signature J Dat/le / I �/ (Revised 10/12/2015) <br />