Laserfiche WebLink
ELECTRICAL PERMIT /kPPL ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ] FAX 425-257-8857 I (E) everetteps@everettwa.gov j www.everettwa.gov/permits <br /> PROJECT ADDRESS: 1 -1m 0►.4.-g• ilv---) \Si" <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF • <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: • <br /> . >Otter-:9 - .•1��(lr�Agl(®��Qddl�®i�if�A`�'60,--. <br /> CONTRACT PRICE OF WORK:$ in- /A-1417.--- <br /> f T re-e--•. .,:... .. ;... ..:_. ._ .. .. _.,:.._>.....-_ :. ... . <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES Q NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 4,---p--- -a l <br /> ••.:T,.,;-:--,..-,-.,..,:::•-.:-. .. .. 0400`HNFOIR 'Y°)ION-:: :, : •• ••.• -• •---,-.... ,-,.:":• •,-•• -:•-•:.,,,,, <br /> .. <br /> OWNER NAME: C- C R &j -.. • TENANT NAME(If Commercial): • <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: CA f... �:c/ 3 - S G A—dy e, . <br /> CONTRACTOR ADDRESS: STREET <br /> CfY STATE ZIP <br /> CONTRACTOR PHONE: t?-r 0.4,„Li 7 CONTRACTOR EMAIL: - <br /> CONTRACTOR LIC.#(REQUIRED) (CITY OF EVERETT <br /> f Fi c�T mwyM1 c„ wn W Y`W`v w. °BUSINESS LIC.#(REQUIRED): VA � �Y �* :. <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: - 3 9__9 OZ., 1-7 - <br /> y CONTACT EMAIL: � <br /> AGREEMENT T hereby certify that l have read and examined this application and know the same to be true and correct Al!provisions of laws and ordinances governing this <br /> type 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> City of Everett Official Use Only <br /> FEE <br /> 0d <br /> -i6a <br /> PERMIT# <br /> �� /-2,1,-1e E 16 O 1- t1 tQ <br /> Owner/Aut orized Agent SI: � Date (Revised 90/92/2015) <br />