Laserfiche WebLink
(r*T. !LECTRICAL 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 I www.everettwa.gov/permits <br /> a�r �E::� e,�u�L 1..�`.\� �,�- '� :r z�z � �.,...�kE�� � ... �']� -£p 'v.ei �.-, k � 'S. •rE.Ti?'a�.`a��:.�� � �x���z�'e -m`l\�s,as „�'`4�'�3'���'>3�a�`a`i a.. <br /> ` X 2 y3 Y"'�eSf. u�,.�'*>7�.::,. . 3,+.E-�vKr.: t ,s \,.a ..\``€ II�ROiR.11w. SIONI ON*1 �.,... .>.Y`r�v.'U.Zx.> `, .c, . .�'0 a«..,: >.,. ,:.t:..r,.. ,�..amu,,: \.w..Yc e� <br /> PROJECT ADDRESS: � ( S C-60kut <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: Sknp,Ce_ -Qv."( <br /> tok �4� k i �y" � \�2.� E s\�.� _\, \g�S`a � .y .'i, f•� e� <br /> 40.#0 <br /> r.a..ai.,. .....,..,w.tro ....._•,a.... .^,.., <br /> wi <br /> CONTRACT PRICE OF WORK: $ 15 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 1�(c.j ✓) Q PX°Vetvie,i eir 1441 kr .- '1c ' <br /> • Q3ctS Fc` p(aC-.e <br /> CONTACT INFORM TION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,�, -��� ' E <br /> CONTRACTOR ADDRESS: STREET ' -CS cf,�C 40-( <br /> CITY ft-tut k (4-42P STATE L A ZIP 7V—is-- <br /> CONTRACTOR <br /> V" "CONTRACTOR PHONE: 1)5-43S- g CONTRACTOR EMAIL: � � <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): C>S 37 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ` - c43`b--' $7 3�5 <br /> -Acr d1/4-J CONTACT EMAIL: +tsjct {lam�ICr� t i•-• (.:cam.. c -- <br /> AGREEMENT:l hereby certify that!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 /> I i /� <br /> �• /�- (S wig E t i5i o - 074, <br /> 0 /Author' ed Agent Signatur- Date (Revised 9/23/2016) <br />