Laserfiche WebLink
----1-pt.cat_ <br /> 0_ 11 , , -fir-YfsFr <br /> ELE .` ICL PERMIT APPLICATION <br /> /111111P'//Z441i'-":a <br /> CITY OF EVERETT PERMIT SERVICES <br /> - 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov { www.everettwa.govtperrnits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 530 ovy - PL <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 62-5;34: <br /> C ) <br /> NUMBER OF DEVICES (if low voltage): <br /> • <br /> FIRE ALARM? 0 YES jii4410 <br /> ASSOCIATED BUILDING PERMIT#(if atoneable): - ' <br /> DES(C�RIPTION OF WORK: & • 1 -AIrlr / - '',. r <br /> CONTACT INFORMATION <br /> OWNER NAME: `' ,/i3-1,_ •r TENANTgNAME(If Commercial): <br /> • <br /> OWNER MAILING ADDRESS: STREET `530 ' "! ` �^�r <br /> CITY G�`"1.t"' d STATE ..JA- ZIA q V <br /> OWNER PHONE: D-6 —4.69 2_-- OWNER EMAIL: ®--- ' <br /> CONTRACTOR NAME: Uti I 3 e--e-i,,.4.,t_, <br /> CONTRACTOR ADDRESS: STREET .-0 43.0,144 6 ic (1� �f'°°) <br /> CITY !' ,, �rt1F ,, pp }} STATE / + Z!�' Q.(..%� <br /> CONTRACTOR PHONE: -- `S d ®tek'3( CONTRACTOR EMAIL: I)t d i'@ d YYVCl1 V Lk"I(4tbfgl e ,A)tT <br /> CONTRACTOR LIC.#{REQUIRED): 1,13tECO E.,-1-I2.I DO CITY OF EVERETT BUSINESS LIC.#(REQUIRED).0/ 3/„ <br /> PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: .4 f' -9,, -- 3 7 <br /> • CONTACT EMAIL: <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be hoe and correct. All provisions of laws and ordinances governing this <br /> type of work wilt 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 slate 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 /> PERMIT# <br /> /1/1)1� �(.644_61,-0A---� „- E p 70q. 763 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br />