Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits <br /> t <br /> PROJECT SITE`INFORMATION <br /> PROJECT ADDRESS: .22.. 0- G1 1.r1 1–/O G G— f►iGck: 0 <br /> BUILDING AREA(if residential, new construction, remodel,or addition) s/2Z7 SF <br /> BUILDING TYPE: 0 SFR-DETACHED $.SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: S P(Z <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ qa(2 <br /> NUMBER OF DEVICES (if low voltage): 10 (apyt/`c, S <br /> FIRE ALARM? 0 YES g[NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Cowie(e.4-L i re 4)- ct2e.,J (10144_1,. 1..C.j/?i1., )ivz - <br /> CONTACT INFORMATION <br /> OWNER NAME: Bit( Lwty�s 1l - RC, NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 22O7 6't bsol/i f C, <br /> CITY Cl STATE l..r/X ZIP <br /> OWNER PHONE: I OWNER EMAIL: <br /> CONTRACTOR NAME: �1_�C5 tC �c I C il—d-j <br /> CONTRACTOR ADDRESS: STREET .22I 9 (el,-- pc( te <br /> crre .. 1:-.0PS STATE C./N ZIP /OL- U <br /> CONTRACTOR PHONE: q-PS?1o0--2m25 CONTRACTOR EMAIL: 0 skye/ecTi-+Liiwa r//cat" <br /> CONTRACTOR LIC.#(REQUIRED): L0,E..SEG$3aCe CITY OF EVERETT BUSINESS LIC.#(REQUIRED):Q5603 <br /> PRIMARY CONTACT: 0 OWNER JCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 72$ <br /> (�> L�(fr/ CONTACT EMAIL: gi 4,,dec L v7�.�ty n�rrj(Cdk <br /> AGREEMENT:t hereby certify that t 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 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 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E <br /> Ownef7Authorized Agent Signature Date (Revised 9/23/2016) <br />