|
477- .ECTRICAL PERMIT AltLICATION
<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 I www.everettwa.gov/permits
<br /> i co 1 " Vjc "a �'e RO �"" i6 e *, ;U
<br /> A
<br /> 110 011410061007414141.1PileMtegraaartiiO4 '
<br /> r.�.�ar ti,� i,�,��^idnNiia ,i �� .��i��,;tea p�"ah�r� �� ',u H���ieas,���ns..� ,,. u iiA��.el oiw�5 0_
<br /> PROJECT ADDRESS: /4107 4 - <Z4� t v/14 qi Zo3
<br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF
<br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: LB"COMMERCIAL
<br /> USE OF BUILDING: A/rIA.,p.,144,n„r imI+-,
<br /> 1=lECtRiCAL APPLI'�ArtK:N INFORMATION. " _,`,7 I ,
<br /> _ �
<br /> CONTRACT PRICE OF WORK: $ i/WO
<br /> NUMBER OF DEVICES (if low voltage):
<br /> FIRE ALARM? 0 YES If7 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): ` r
<br /> DESCRIPTION OF WORK: 2 t G7 x3000 V<^ rm .y (
<br /> be/ nem) po,_x --pcK rp„N,e_g ,..
<br /> ,- ,4,=IN � ''k�'� , gtdarva ' ,N jv i'y r
<br /> CQN ' #CORMA '�
<br /> t� t
<br /> OWNER NAME: - A T 1 1.e5 05/4 TENANT NAME(If Commercial): 4. I.' fl _. (/S
<br /> OWNER MAILING ADDRESS: STREET /L1D? 741^— S•-1-, tet.)
<br /> CITY ""v.efeA , STATE i,tiA ZIP C,g.oe.7
<br /> OWNER PHONE: ('/ c) S 2)--1O0 D OWNER EMAIL: "614,OY,Ake ac,/4,;(te S u,,GC c Got'''`
<br /> CONTRACTOR NAME: fr.OC675 SUWll U NS Inc:
<br /> CONTRACTOR ADDRESS: STREET "7 1(Z VI^ AI (Ai S -i-a-et-46)
<br /> CITY Ski(1100(, STATE IC ZIP 782-9 2—
<br /> CONTRACTOR
<br /> CONTRACTOR PHONE:(-j 2O) Liu-3=702i CONTRACTOR EMAIL: eA t I.G be pcoce 9Sy6 ufrm c c(AAA-
<br /> CONTRACTOR
<br /> L"tiCONTRACTOR LIC.#(REQUIRED): Pao Ce, I � LI
<br /> CITY OF EVERETT BUSINESS C #(REQUIRED):©1
<br /> � n,.m.�AR1a
<br /> PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME:``` . CONTACT PHONE: (`3 O 1 (..t0-j�--7 63-7 ,e),4_ I
<br /> .a \ CONTACT EMAIL: eA oe e.,,,,,,,s fo ijram S( Cdl &
<br /> AGREEMENT:I hereby 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 type
<br /> 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 18.27 RCW and 296.200 WAC.
<br /> City of Everett Official Use Only
<br /> PERMIT#
<br /> ,.. 4//)? E (.70 -3— 153..Owner/Authorized Agent Signature Date (Revised 9/23/2016)
<br />
|