Laserfiche WebLink
APECTRICAL PERMIT APOEICATION <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 I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:1 L b G\.29ceer Wo.k4G19- QwCD3 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) COO SF <br /> BUILDING TYPE: o SFR-DETACHED o SFR-ATTACHED o DUPLEX o MULTI-FAMILY-#OF UNITS: ,COMMERCIAL <br /> USE OF BUILDING: OC SU7 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? -ES o NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: \\\\S\-C,,\, 'tekt) o- ( J ZQA.6,l0 n i 'i-or _-_ <br /> p �� DCONTACT INFORMATION <br /> OWNER NAME: Q\j O �-�'�/` e (('��,,TENANT NAME(If Commercial):C \ V'-QQ' p O1C12;Var1. <br /> OWNER MAILING ADDRESS: STREET ` J V)ox 530 3 <br /> CITY Ake,v -12, STATE WA- ZIP a q <br /> OWNER PHONE:14 L514 (OWNER`EMAIL: <br /> CONTRACTOR NAME:Gpeks--A,Vc-V12 <br /> CONTRACTOR ADDRESS: STREET 1�`t-kJS �f <br /> CITY Q. STATEUA.- <br /> CONTRACTOR PHONEa CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CIU (CITY OF EVERETT BUSINESS LIC.#(REQUIRED). (4U3 <br /> PRIMARY CONTACT: o OWNER o CONTRACTOR OTHER(Please Specify)aci0\cI(\,A <br /> CONTACT NAME: CONTACT PHONE: ( <br /> p `e <br /> cAc CONTACT EMAIL��skS ed;bj1/4 jar&ZCiYCectiY <br /> ` <br /> 4-'leo� C614/ <br /> AGREEMENT.:I hereby certify that I 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 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 /> 5/0-it E -- dao <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />