Laserfiche WebLink
�EECTRICAL PERMIT AP�ICATION <br /> C{TY OF EVERETT PERM{T SERVICES <br /> 320Q CEOAR STREET, EVERETT, WA 98201 <br /> (P�425-257-881C} � FAX 425-257-8857 � (E}everetteps@everettwa.gc�u f www,$V@f@�W8.�4YI�t@E'ITIEtS <br /> PROJECT StTE INF4RMATIt�W <br /> PROJEGT ADDRESS: � � � 2�c:(t�r� �a"� vt r-� <br /> BUtLDING AREA(if residential,new construction,remadel,ar addition) \ SF <br /> BUILDING TYPE: O SFR-DETACHED ❑SFR-A`RACHED D QUPLEX ❑ MULTI-FAMtLY-#OF UNITS: ❑COMMERCIAL <br /> USE QF BUILDINO: <br /> ELEC1itICAL APPLICATItJN INFt1RMATit?N <br /> CONTRACT RRICE QF WORK: � ���, ��`'' <br /> NUMBER OF DEVICES if low vaita e : <br /> FIRE ALARM? �YES NO <br /> ASSOCIA'T`ED BUILDING PERMIT# if a licable : <br /> DESCRIPTtON O�W�RK: (7 J ��w" �p �T�'�.F'r�.A-t.-t: <br /> CONTACT INFORMATIClN <br /> OWNER NAME: t��}-dY} ;�` C.�,tx-�lC,� TENANT NAME ff Cammercial : <br /> OWNER MAILING ADDRESS: s�rzeEr ` (�, � �(��k..���l,���--- �l�� <br /> CITY -`�,,,,,�'Y�l"t"' STATE � 21P <br /> OWNER PHONE �25 Z.-Z.C`� ` �'��'ly UWNER EMAIL: <br /> CON`I'RACTOR NAME: ���1����R.�.. �� l.h%��'r"� G <br /> CONTRACTOR ADQRE33: sr�er i Z.3'�.y �Sr=y�i.t�or,. t�1� <br /> c�rv �.�,�.=�i•,i's3..y STATE {,.,} zta '�',. ..� <br /> CON7RACTOR PHONE: �f�3 ,.5 S�6 - � �L'Z CONTRACTOR EMAIL: �.�r li�1--��E.e°. �%+'� A�t. t���.. <br /> CONTFlACTOR LIC.#(REQUIRED}: Vf��D��,;, ' ��,,�" C1TY OF EVERETT BUSlNESS LIC.�{RECtUtRED): C��� J <br /> PRIMARY CONTACT: �V+�NER 0 CONTFtACTOR �OTHER{Piease Specify} <br /> CONTACT NAME: ''���,, .,�.�,j�� CONT�kGT PHONE: "'��� v��s� -- ( ��-� <br /> iGC►1�TEtCT EMAIL; <br /> AGREEMEfllT.�t hereby c+ertify thet 1 have�errd exemined this eppli�ation end krnsw the sarns to be Hue artd correcf. Ait provisions oi/aws artd oniinances goveming this type <br /> of work wiJi be cnmpJeted whether��h'ed herein or not. The grenting ot e pemrif does not presume ta gnre euthorify to vio/ata or cence/the provisfons ol eny other state or <br /> locai/aw regulating construction ar dre pertamsnce of conatructio». That!am euthorized by the owrrer ot thJs pmperty to perfam the work tor which appticetro»is maata and 1 <br /> compiy with ihe Stafe Corrbectws l.ew 18.27 RCW arrd 296.200 WAC. <br /> Clty af Everett 0lficia(Use Only <br /> PEF2MIT# <br /> � � � 1 ��- �! � � � � ` � I <br /> Owner/Auttwrized Apent Siynature C}gte (Revrsed 9/7312016) <br />