Laserfiche WebLink
ELECTRICAL PERMIT 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 SITE INFORMATION <br /> PROJECT ADDRESS: -'` � (�j ' � � � �° <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF � ji.. '� (% <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: �1 COMMERCIAL <br /> USE OF BUILDING: <br /> E TC�k APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: n c`� P� <br /> NUMBER OF DEVICES (if low v tage): <br /> FIRE ALARM? ❑YES <br /> ASSOCIATED BUILDING PERMIT# (if appli able.�: <br /> DESCRIPTION OF WORK: - ,f j_ _ / j 2 <br /> -- C'G � i^" �/ . �/ "GrC l" �t � � J"'(' l � -�,- � ,----- <br /> . <br /> ,� .r---�. , <br /> � -L��-v=- Z .L � �r - c' �� �, v ` � <br /> < <br /> CONTACT INFORMATION <br /> OWNER NAME: C � /)(/t C TENANT NAME(If Commerciai): <br /> OWNER MAILING ADDRESS: srReeT S/ ' ' <br /> � J <br /> CITY ��' ' � STATE CJ ZIP �`J � � <br /> OWNER PHONE:�'�,;J �. ? ^ „ L� OWNER EMAIL: '—'� ' �;^' �� �. "-�% L . ^'��' <br /> CONTRACTOR NAME: ' ' C ' <br /> CONTRACTOR ADDRESS: sTReeT <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> �L CONTACT EMAIL: <br /> AGREEMENT.1 hereby certify that/have �ad and examined this application and know fhe 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 pertorm 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 /> _-___�� _ __ a��� � E ��� _ 0 2 � <br /> �Q lAui#a� gent Signature Date (Revised 9/23/2016) <br />