Laserfiche WebLink
�.�ECTRICAL PERMIT AP�IGATIt�N <br /> ClTY OF EVERETT PEFtMtT SERVICES <br /> 320fl CEDAR STREET, EVERETT, WA 882d1 <br /> (P)425-257-8$'!tl ( FAX 425-257-8857 � (E}everetteps@everettwa.gov( www.evere##wa.govlpermits <br /> RR�3JECT SlTE 11KFt3RMATlOi�1 <br /> PROJECT ADDRESS: �.-�.1 L-J�,�t �'}.pv1�.,n'k'.�r 'j C>{� v'�.p�,�,) �`�,r•. F'v e„r,�C �.,j�1 �1�2�3 <br /> BUILDING AREA(if residentiat,new construction,remodei,or addiUon) '��-O4i" SF �` AQQ��X. '�p Xy0 <br /> SUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATI'ACHED D DUPLEX ❑MULTi-FAMILY-#OF UNIT3: r CQMMERCIAL <br /> USE OF BUILDINC,y: 5 �,,,� Cx�� -� pY}�,b� � ��� �.,y.�`S�� <br /> EI.ECTRICI�L/4PfiLICAT1aN t�I�ORMATIGN <br /> CONTRACT PRtCE pF WQRK: � (`, p 3 <br /> fVUMBER OF QEVtCES if(ow volta e : <br /> FIRE ALARM'? ■YES ❑NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> DESCRIPTION OF WORK: <br /> c��ti,^ �.�e.t ��-�7 ��'v t �--� �'-e�`i.e..c,�ptiM �3�a�Y� <br /> f�P..t�J �r' a a--�' 5�.�`� � <br /> CtaNTACT INPQRMATICIM <br /> 01NNER NAME: �v.er ct,�t Qv��l;c, �j�1��c�a� '� TENANT NAAAE tf Commerciai : <br /> OWNER MAILING ADQRESS: srReer 3��C�p ��v.!� <br /> CtTV 'CV'$Y E.� STATE W.� ZIP E3 L V, <br /> OWNER PHOPiE: '��-�- '��S " `i� � S OWNER EMAIL: �C m�1 i�5� ey 2,t'e.�' S� . cp,�-� <br /> CONTRACTOR NAME: S��..�2 �,� E�,�'1 C„ i.n C . <br /> CONTRACTOR ADDRESS: STREET � 'LZ, ��" �1 Q,� l,''1 <br /> ct�v V.�✓� sra're � z� pl��.L�?�f <br /> CONTRACTOR Pl10NE: �'3`�� y�`'t- 2.�'aZ CONTRACTOR EMAIL: � �"'�'V �5 E S�'�.'�'Q„2C._r`,p,N1 <br /> CONTRACTOR LIC.#(REQUIREO): S �C��,�� g�� G S Cil'Y OF EVERETT BU5INESS LIC.!�{REqUIREO): <br /> PRIMARY CONTACT: C7 t?WNER �CONTRACTOR ❑OTHER(Please Specity) <br /> CONTACT NAME: � CONTAC7 PHCENE: ti..{"z„`'"j-- � "1 -""� � �S�j <br /> ����� t� C�NTACT EMAtL: 7,-tit't s <br /> '�'"'� �'���-C?�.C.• t.,.�'� <br /> AGREEMEN7:T he�eby carU/y ih�t l itaue�ad and examined this applicetran and know tha sarrra fo be hue and correct. Ati provisions ot taws and ordinanCes goveming this <br /> type of work witf be eompleted whefher specified hererin or not. The granfing of a permit does not presume lo glve euthodty to violsis or cancel dhe provJstons of any aiher stefe nr <br /> local!aw ragutatrng aonstruction or the performance of construciinn. That!am autho»zed by ttte owner of tAfs property to perfortn the wak far which applicafion is rrteda and F <br /> comply wlth the State Contractnrs Law 98.27 RCW and 296.200 WAC. <br /> City of Evereit OiltcFat Use Only <br /> FEE <br /> �� rr <br /> `� �`��- Cv� <br /> �/ 1, �i ��.n��� <br /> ,�,��� � , ._ PERMiT#t <br /> . a <br /> � �— � I �-� � �� � <br /> r,. <br /> ._ : <br /> � � D �'�f/o <br /> _ ,; <br /> OwnerlAufhorized Agent Signature `� Date (Revised 1QH?l20?5) <br /> l .r•� <br />