Laserfiche WebLink
�ECTRICAL PERMIT A�LICATION <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 /> ' Rti+DJECTY3ITE IN�t3RMATI�JN <br /> � E : . . _, ,_._ �._ . ___. � f <br /> PR�JEC7 ADDRESS: tp U� S� �J���-� UN°`�� �0. � <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: �COMMERCIAL <br /> USE OF BUiLDING: S 1 � '�tn��Cc I� ct`YU� <br /> EI.ECTRICAL APPLICATIQN INFORMATION <br /> CONTRACT PRICE OF WORK: $ (1,0(� <br /> NUMBER OF DEVICES if tow volta e : <br /> FIRE ALARM? ❑YES NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: <br /> S Ct fM d � , <br /> �/t G tn e. �/"' G�i � tf � <br /> v� a L-o c� 6 � <br /> , <br /> CONTA�'T INFORMATION <br /> OWNER NAME: i�, P�( TENANT NAME If Commercial : �� Gt� Gc <br /> OWNER MAILING ADDRESS: srneEr � bc2t �Q,� L�� � �� <br /> CRY ��1 Q STATE � � ZIP v <br /> OWNER PHONE: �6 ~��G�`' ���' 0 OWNER EMAIL: <br /> CONTRACTOR NAME: �QC3ti S S�uv� <br /> CONTRACTOR ADDRESS: s�rne� <br /> CITY � (jO� STA7E � ZIP � � U � <br /> CONTRACTOR PHONE:�a�`Sd� "� ���{'� CONTRACTOR EMAIL:�'Q D� W��'S �U-�U ,CCiti+^' <br /> CONTRACTOR UC.#REQUIRED): � pvt i�. 0�n(P CITY OF EVERETT BUSINES UC.#(REQUIRED): q� <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR k30THER(Piease Specify) 1 l� �a`rv� �� <br /> CONTAC7 NAME: CONTACT PHONE: C{'� > �� — "� <br /> � CONTAC7 EMAIL: Q,{��Q,J�YL�� D <br /> AGREEMENT.•I here6y ce ify that 1 have read and examined this application and know the same to be true and correct. AU provisions of laws and ordinances goveming tiris type <br /> of work wil(be completed whether specified herein w not. The granting of a permit does not presume to give authority to violata or cance!fhe provisions of any other state or <br /> locat!aw regulating construction or the performance of construction. That i am authorized by the owner of this property to perform the walc for which application is made and 1 <br /> compty with the State Contractors Law 98.27 RCW and 296.200 WAG. <br /> City of Everett Off'icial Use Only <br /> PERMIT# <br /> �� �-�/�, E I'�� - 2�Z <br /> Owner/Authorized Agent gnature Date (Revised 9/23/2016) <br />