Laserfiche WebLink
0 /4J9a5- ySo�. oaV r�330 <br /> ELECTRICAL PERIlP T ,APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT$1 I INi;O1tM41T10N <br /> :... .. . <br /> PROJECT ADDRESS: <br /> BUILDING AREA(if residential,new construction,66-d-1,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED-, ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING: OEC G <br /> L:BGTRICAL APpLI AVON 4#0 <br /> CONTRACT <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage):, <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT#(if a licab <br /> DESCRIPTION OF WORK: <br /> CONTACT INFORMATION. <br /> OWNER NAME: TENANT NAME if Commercial): <br /> OWNER MAILING ADDRESS: STREET box 3 <br /> CRY STATE � l/ 7J IZ "2207 <br /> OWNER PHONE: OWNER EMAIL: 7 <br /> CONTRACTOR NAME: /v <br /> PPRIMARYCONTACT: <br /> ADDRESS: STREET Pa SOX <br /> CITY � /L [� sTA,EI/I/�t- zi <br /> 'I n <br /> PHONE: "Z " Y CONTRACTOR EMAIL: /E f'. /Y���ie CD/l'? 4 <br /> LIC.#(REgUIRED): G�nl�let� �tD z CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�O <br /> ACT: ❑OWNER 19 CONTRACTOR ❑OTHER(Please Specify)E: pCONTACTPHONE:I S �1�-f7�11� CONTACT EMAIL: DENN I'S.6A0LV 0 /:�E'W 1 T, 6041 <br /> AGREEMENT.,Thereby certify that I have read and examined this application and know the same to be true and correct Allprovlslons of laws and ordinances governing this <br /> type of work will be completed whether specf led 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/ <br /> comply with the State Contractors Law 18.27 RC and 298.200 WAC. <br /> City of Everett Offlcfal Use Only <br /> FEE <br /> 4a , <br /> PERMIT# <br /> Ownar/Au orized Agen Signature Date (Revised 1011212015) <br />