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 /> : � ���'\ ���������a%����� �����` � ` � ti <br /> ::'1 .�k:�� .. .... : , „F,........ ........ .:Z��i i:..�...� ..... _ .._� .....a:.:.... . � .�.'.�... �..� ' <br /> � u��. <br /> PROJECT ADDRESS: , vere , , <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: reSIC�eC1Ce <br /> � � n <br /> i.'� ���� �y��� ..� <br /> �� Z. �� ������ �.� ��� } <br /> CONTRACT PRICE OF WOR $ <br /> NUMBER OF DEVICES if low v e : <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT# if a licable : <br /> oescRiPTioN oF woRK: new outlet on landing, new circuit for outdoor power <br /> -: �._ .... :. �\ � �a� �� <br /> � *�'">;� <br /> � <br /> �.�� � <br /> N <br /> � ��,..���, � .��.� ,�: <br /> �„,...�.._ ," . ,.,. �. �.,:_. .�. � :;: . <br /> OWNER NAME: ROI�eI'�W1tSOtl TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS: srneeT 7 <br /> Everett WA98203 <br /> CIN STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: parkeCSClalla comcast.net <br /> ..... . <br /> CONTRACTOR NAME: B�aCk Slle@p EIeCtYIC <br /> CONTRACTOR ADDRESS: srneer 4320 196t t <br /> ynnwoo WA 98036 <br /> CIN STATE ZIP <br /> CONTRACTOR PHONE: 2066616516 CONTRACTOR EMAIL: keVIt1S blacksheepelectric.c <br /> CONTRACTOR LIC.#(REQUIRED): aC Se9Z4J CITY OF EVERETT BUSINESS LIC.#(RE ,REo�:58166 <br /> . .. _.., .,�..�___ <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 2�6-661-6516 <br /> KeVlll Slllltll CONTACT EMAIL:KeVIC1S blacksheepelectric.com <br /> AGREEMENT:1 hereby certify that I have read and examined this application and know the same to 6e true and correci. All provisions of laws and ordinances goveming ihis rype <br /> of work will be completed whether speci/ied herein or not. The granfing of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> local law iegulating construction or ihe performance of construction. 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 /> Kevin Smith 5/1/18 E � p O� ' �� � <br /> Owner/Authorized Agent Slgnature Date (Revised 9/23/2016) <br />