Laserfiche WebLink
i <br /> ELECTRICAL PERMIT APPLICATION <br /> j- 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©everettwagov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: i aSO; a( Q' <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED ''❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> � �q��li„,,' ,f',/i,/i/ii'//%mo' ii i/o ip,':' ii/io/if7",;777% ,/%9%?/' <br /> %Dij/u':0�� ;', // <br /> ""`� ��j' ` '--, G//%'O�//1,, �0// /%%%%///////'!:31%,','O//%%OJ;O%/D////f//D/O%%�%/DM/�//O'D,'' b ��/ / <br /> CONTRACT PRICE OF WORK:$ a-00. °' <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES NO <br /> ASSOCIATED BUILDING PERMIT#(if ap licable): <br /> DESCRIPTION OF WORK: h✓'!'14 Gz, cW/Te-ft- <br /> OWNER NAME: ' i tom. "Sip V o. .vs" TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET (a'Z30, a-(gt- /--s e- <br /> CITY . 0 STATE ZIPCI8( <br /> OWNER PHONE: 1-01D-3(3_C( 3 OWNER EMAIL: <br /> CONTRACTOR NAME: L t/✓c P.t/ -eLe c1/t G <br /> CONTRACTOR ADDRESS: STREET (/( 4 <br /> 7c0 (8C* 4/x IV v//�:Fo n <br /> CITY 1 e-ev OL n STATE 4-41---- ZIP t 2_ <br /> CONTRACTOR PHONE: {e ' 'lam-a 7,62/ CONTRACTOR EMAIL: loll((CE((Vi -P cGe elde - CzA"L-- <br /> CONTRACTOR LIC,#(REQUIRED): L./AIX-E.-1(24 IAA9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED); 1&70 o` <br /> PRIMARY CONTACT: ❑OWNER )bONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 1/0-c--8.6,it-y q 7 2---- <br /> IM( .. Li0 -%Ti(/ CONTACT EMAIL: 1441(0 f 4d€ 2 (.e¢. rC .Ce,L <br /> AGREEMENT:I hereby certify that/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 /> / - PERMI #dier '7 0 j Wsr'' <br /> Owner/Authorized Agennatt4e Date (Revised 9/23/2016) <br />