Laserfiche WebLink
ELECTRICAL PERMIT AP�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@everetfinra.gov � www.everettwa.gov/permits <br /> '' PROJECT SITE INFORMATION ' <br /> � t..� _ _. -� <br /> PROJECTADDRESS: 'j I �� C`,I C� � ��( ��'� <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL <br /> USE OF BUILDING:'��'-� �,l �` �J' TQ�l� <br /> ELECTRICAL APPLICATION INFORMATION <br /> 0 <br /> CONTRACT PRICE OF WORK:$ Z. Q� <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES 1�N0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): /�� <br /> DESCRIPTION OF WORK: �/Y1�`R, �I�G`� L. �Yl�"NT" fl� �-ZC"C.T2+CA�L <br /> ��L. � t7 �`(� � �3 l.���2 �.E <br /> CONTACT'INFORMATION <br /> OWNER NAME: ��'J���"�'(�.��" (_�� � TENANT NAME(If Commercial): �1�,� <br /> OWNER MAILING ADDRESS: sTReeT s I O� �V�R.�2.�E 1� l�R� <br /> CI1Y �V�t�—�� STATE �� ZIP �g C.S..J 1 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: '�"r�� --��G J IZ.1 � <br /> CONTRACTOR ADDRESS: srReer � �x �j (Z� <br /> CITY ���'t��,_,� STATE w � ZIP 1 U� 1� <br /> CONTRACTOR PHONE:LJZ_j-�� (Q CONTRACTOR EMAIL: p`'h�� {'e,� � eL,'�'1`lG e � <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC,#(REQUIRED):Q � <br /> _. _. , _ <br /> PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: � 'L ..- �3— � � �� <br /> [�-e � \��ulTl�t� CONTACT EMAIL: `�f" �e,�e.��' E.�' �.,�r i G, �,� <br /> AGREEMENT.�I hereby certify that I 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 fhe provisions of any other state or <br /> local law regulating construction or the pertormance of construcfion. 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 /> PERMIT# - <br /> ' J E � � �l�� �� <br /> 1 � <br /> Own /Authorized Agent Signature ate (Revised 9/23/2016) � <br />