|
ELECTRICAL PE MIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)428-257-8810 j FAX 425-257-8857 I (E)everetteps@everettwa.gov j wwwv.everettvva.gov/permits
<br /> _•sya..•.yY-�'1 r,�lf' i��• 1:-;5.�:_�:•y�:-•♦'n i•Yt _.•�.._......•...e,w�..�•..a•,...t-v i �.T•.•.r+.'K.t+l^'ay.a.,4... .fit - �l•. �f�..•r,�> .-.��..�—.}I'.r: _ �_ry 'V
<br /> t.t.:os.'-ti-.C.. .� .•..r... .a. "..RL.n .v. .. .t�:« .r-04.5�- a.r•.h•.w.tNl.... ,r.il::rt_.a.ei'+r:�sCt.r aster_••. .,.. �..... .:s i...... ...-. >-. ua ... i .r ..J
<br /> PROJECT ADD SS: t)— C " 4.$ ,"a 1 ga;, 0,6 k
<br /> "40
<br /> BUILDING AREA(if residential,new construction,remodel,or additiarlf SF
<br /> BUILDING TYPE: f'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX Ci MULTI-FAMILY-#OF UNITS: j COMMERCIAL
<br /> USE OF BUILDING: '06-/A.16 EVERETT- •
<br /> �;y�,•.,t:Ys•:,,rot n ti, :• •t.v.,.. ` -a - - .K<,n:,2 .v;..r.l: •.nh-;•tYri ,�g�.._a6��
<br /> ,: .. • r ,(^aT 1t°t s j-,LE# "�F! Q43S�Ar ®�+dl 1< ORN AT601f r : A• ';:`„..,: '•;• •.::• J.•
<br /> ,k4QT.4•.$iyr,-:y •.._-.: .:.A,.. .'s.,_.. :.?k:-+.ez a...:atsYt',..s a v ...e:0MT Utsn•u._.-e v 01.6,0 'T ia.;eev...,,,--.. «s.:S:�U.'f•}.i l's•k".—:t.vrllrli•1�.:.Aea n 1••ai..v.i i.'•K CONTRACT PRICE OF WORK:$ )(2.,/000
<br /> NUMBER OF DEVICES(if low voltage):•
<br /> FIRE ALARM? 0 YES NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): •
<br /> DESCRIPTION OF WORK: c , V,.I k -,) (c,t.) .<..„ :� 1)
<br /> •
<br /> •
<br /> . ' .,..:,._ . .. ,:. :. .: .'•: ; 0 `>l�A 'IE:)i,NEORMATIO ,' _. . .' _}j ...,_.
<br /> OWNER NAME: TENANT NAME(If Commercial): Be3eliti6
<br /> OWNER MAILING ADDRESS: slaw Po &'( 37o7
<br /> cuy 5EATTGE STATE W>4 210R22 2207
<br /> OWNER PHONE: OWNER EMAIL:
<br /> CONTRACTOR NAME: -1)6E& , i0,577etJ T/bM-)
<br /> CONTRACTOR ADDRESS: smear Pr 60X 4/,
<br /> cm, m/% vpggP2th
<br /> CONTRACTOR PHONE:I -.2/4-61 44 CONTRACTOR EMAIL: kA-ei. H, /�'�E-jeP CO/Y1
<br /> CONTRACTOR LIC,#(REQUIRED rV �C D z CITY OF EVERETT HUSLNESS LIC,#(REQUIRED):O I05
<br /> PRIMARY CONTACT: ❑OWNER RI CONTRACTOR 0 OTHER(Please Specify) -
<br /> CONTACT NAME: CONTACT PHONE: 204, 736--654- ,
<br /> .D Ni f 5 LI-.OW CONTACT EMAIL: DENN 1S.e.KDiI 4 1.5.! 'V'/'t
<br /> AGREEMEND T hereby cerafy that I have read and examined this application and knowthe same to be true and correct All provisions of laws and ordinances governing this
<br /> type of work will he completed whether specified herein ornot. 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 em authorized by the owner of this property to perform the work for which application is made and
<br /> comply with the State Contractors Law 16.27 RCWand 296.200 WAC
<br /> City of Everett(kola/Use Only
<br /> FEE
<br /> PERMIT#
<br /> E ( 0 .6-- 6(02
<br /> Owner/Au ortzedAgentSignature Date Revised 10/12/2015)
<br />
|