Laserfiche WebLink
ELECTRICAL PERMIT APPLIC TION <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 /> PROJECT SITE INFORMATION'. <br /> PROJECT ADDRESS: 60.4 q0-1 S- W E‘)Q J(4-1 V ' Sid( `9 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) Re!ho)2 f SF <br /> BUILDING TYPE: 0 SFR-DETACHED SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: -tot't <br /> LEC 'ICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ f 406 .0 <br /> NUMBER OF DEVICES(if low volta e e):• <br /> FIRE ALARM? 0 YES a 0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: ' ) S Abl4S-C fi64f1 <br /> CONTACT INFORMATION.. :. <br /> OWNER NAME: S CL s /.j 1 I )) / TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 6 I a I b "' ,`j 1 s A)) <br /> �J/�� /D <br /> e f e-} /-1 cm, I STATE IAA P 1 ZIP gYe;16 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: C 0 v f C(�t1 al\� I e C i '(I (t( <br /> S ea Ce$ ( L C <br /> CONTRACTOR ADDRESS: STREET I b O l) d elU S re- <br /> CINE L ti Ke 14I✓Y 5 STATE 1/1/ ZIP T 9/ <br /> CONTRACTOR PHONE:t�S 3 S,U I 9 0 p r CONTRACTOR EMAIL: I y)C ke R" (p c ( C/ vt-ct L <br /> CONTRACTOR LIC.#(REQUIRED): Cb 6,13,srP S g0 CITY OF EVERETT BUSINESS LIC.#(REQU ., D): ' <br /> ao <br /> PRIMARY CONTACT: 0 OWNER 11CONTRACTOR 0 OTHER(Please Specify) T.1 <br /> a}, " y 3 a r <br /> CONTACT NAME: ) CONTACT PHONE: [' c1i <br /> ic )t1 Q e �1 CONTACT EMAIL: 3 �� f <br /> Ky it ke r/) (es"�5-viR) ) <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 eo <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 l 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 /> IVO 0 <br /> PERMIT# <br /> 02 <br /> 7 E r -0(0 - it 2_, <br /> Owner/Auth .AgentSignature Dat <br /> .- (Revised 90/9212095) <br />