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ELECTRICAL PERMIT APPLICATION <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)everre!^ttteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT ADDRESS: 2111 Oakes Ave <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: IN SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Residential <br /> 741T i,,,,,, o x v r t <br /> CONTRACT PRICE OF WORK:$ 350.00 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Install outlet in crawlspace for sump pump <br /> PaNglietW v -i tri>���'` � "�" �(�/�. � x �. <br /> °e?�e „:', �`t; �i#F .,.,,. .., ac>, .:....... <br /> OWNER NAME: Dana Connolly TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2111 Oakes Ave <br /> cmr Everett STATE WA zip 98201 <br /> OWNER PHONE: 425-303-3382 OWNER EMAIL: <br /> CONTRACTOR NAME: Cisco Electric, Inc <br /> CONTRACTOR ADDRESS: STREET 22612 92nd Ave W <br /> cm Edmonds STATE WA zip 98020 <br /> CONTRACTOR PHONE:360-618-3038 CONTRACTOR EMAIL: maria@ciscoelectric.com <br /> CONTRACTOR UC.#(REQUIRED) CISCOEI914DE CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042432 <br /> PRIMARY CONTACT: ❑OWNER VI CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 360-618-3038 <br /> Maria Nicodemus/Cisco CONTACT EMAIL:maria@ciscoelectric.com <br /> AGREEMENT*I hereby certify that 1 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 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 /> PERMIT# <br /> 2�9 0 3 E [QO2_ ot5fas <br /> Owner/Authorized Agent Signature Date <br /> (Revised 9!23/2016) <br />