|
ELECTRICAL PERM�T APPL1GATt�N
<br /> CiTY QF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> {P}425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everetiwa.gov/permits
<br /> , < „_.
<br /> .;-
<br /> ' I���� ` ��;��"��"��� , ��'t'���_ _
<br /> f'ROJECT ADDRESS: Q.2'' , � , _ _ ;
<br /> BUt�DiNG AREA�If resfdential,new construction,femodel,or atl1�6i94�� SF
<br /> BUILDING TYPE: L7 SFR-DETACHE� ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL
<br /> USE OF BUILDING: _ _
<br /> �� �`F �g ��.-� 4 $ .. . . .. . � .. .
<br /> 5 ,�i.c^ 4:,.� ...��. � .. . -, ,��., : Y . . . ... . .
<br /> :. .... . . , . = , . ';'����'`��tt��k ...�?'!�►� + ":..��� �',�� `��+[�ihil
<br /> � . .. .
<br /> CONTRACT PRECE OF WORK: $ � E''' .
<br /> _ _: .
<br /> NUMBER OF DEICICES. if Iow volt� 'e : '' "
<br /> , _
<br /> fiRE ALARM? �YES _ (�p
<br /> _ _
<br /> ASSOClATED BUli.DlNG PERM.IT# .�f a plicable::
<br /> ....�� �� ,��"��.�.���: _ .` .� ��
<br /> � ��
<br /> _.
<br /> �
<br /> '� � �,�,<:���� �, .-� " f, `�1�� ����. � ,,
<br /> . 4 , �. ..
<br /> , .. s �. ,_
<br /> �.. .
<br /> , . �.. � . .::
<br /> , � ,
<br /> . , ., . , �.�a ,tt ,..,i_ 5 - ,.
<br /> �nx^ .• � _ ., - _.
<br /> `OWNER NAME: �. 7ENANT NAME,{if Commerc[att;
<br /> . ��' __. _
<br /> ' OWNER MAIIING A�II �; STREET�,�,
<br /> _:
<br /> .. _... C� ;., ;. .,, ... .. ,::: STATE. W r 7�._ .. ZIP ' ,� � .:
<br /> OWN�R PHONE: � ��, . �P(DO OWNER EMAIL: ,
<br /> _. .. �.
<br /> �f3NTRACTUR NAME; •�
<br /> CONTRACTOR ADDRESS: srr�eer � �'' ��}�
<br /> cirr ' • ., ; ��
<br /> � � � - ° STATE - � Z1P�.. �
<br /> CONTRACTOR PNONE: � ` _ G�1['+��GTCtR�1�Al�iL: ,. ' '
<br /> t'��!'ff� . . < . � {R�QU1.5��.� �
<br /> �
<br /> �� _. � �1'f`!"�'f��1IL�E'�"'�'.���ri��S��.1C �QC��kt����: "..., a__�.:
<br /> �-._ ._ � _.
<br /> #�RIMARY CON7ACT: O OWNER CONTRACTOR ❑OTHER(Please 5peclfy}
<br /> 'CONTACT NAiIAE;: CONTACT PHONE: � _
<br /> � � ��� ��
<br /> �
<br /> � .�����I�. , CONTACT EMAfL: � - "«
<br /> AGhs��d4f�1+lT! _ ` � ���� '���
<br /> �+��er�tYy�ihet have read and exeminad thls appflcatiort and know the same to be hue and conect A!I prows�ons oflawa and ordinances goveming fhrs type
<br /> otKrpt�zy�jt/bs cc>rn�u'���yy��ther spect�ed hersin or not The granting o(a permlt does not presume fo give eulhodry fo vlotate or cancel the provlsJons of any other stafe o�
<br /> local faw regulafing coristrvotion or the perlormance o1 consiruction. Tha�f am aufhodzed by fhe owner of this properfy fo perform!he woric fir whJch app!lcafton is made and 1
<br /> comply wilh fhe Slafe Confractors Law 18.27 RCW and 295.200 WAG.
<br /> City o/E�srett Oftfc/a!Use Only
<br /> PERMIT#
<br /> � ��,�� - �.�:�. a��a ��� E I�b2 - f/�'(�
<br /> Owne���r�th.�ri'�eti Agent�igtaatfti�e � Date _ lJ
<br /> (Revlsed 9/23/2016) ' '
<br />
|