|
ELECTRIC L. PES- SIT APPUCATIIONb2zc2.7ra1T:3
<br /> .111 CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET, EVERETT,WA 98201
<br /> (P)425-257-8810 j FAX 425-257-8857 I (E)everettaps@everettvva.gov I www.everettwa.gov/permits
<br /> ... a ..,r..._....... .. ... ....,. ........ ., . .. ....•,:. ,.Q�_r,. r_..-•♦:�-.:•:.:_, ,.. .:.,�/�:. 1. v., ._.rte. .. . _
<br /> PROJECT ADDRESS: Q � CeA la 1 l.b1 (.�v)i+ 1 '-
<br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF
<br /> BUILDING TYPE: ID SFR-DETACHED 0 SFR-ATTACHED- D 0 DUPLEX LI MULTI-FAMILY-#OF UNITS: COMMERCIAL
<br /> USOF BUILE DING: ;0E1/4& Et/ E r t •
<br /> � -.i -r 2 _ _ -L j,,srpp...rs,;•• �i 4`e �o�` r•,,.r..a.;,..:.. r.. ��.•c•o `i'_.. ,
<br /> FARM i'IOl(� •,,-,,, •„
<br /> CONTRACT PRICE OF WORK:$ 49 t /O 0
<br /> NUMBER OF DEVICES(if low voltage)»a
<br /> FIRE ALARM? ❑YES 74 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable): S
<br /> DESCRIPTION OF WORK: B j VY7 1 U O t 00 61) v-03- -\._ci I��
<br /> r777Y1Ma p):90\i . Oil e -
<br /> - tC[?I�7'ACT;INIFORiV�A7'IOii�. - ;
<br /> OWNER NAME: TENANT NAME(If Commercial): /R•)6
<br /> OWNER MAILING ADDRESS: STREET c�,,t�/���Ise) 5707 y��7�( 'J
<br /> CITY .5eit�I l LGr • STATE VV/1- ur I g/21 2207
<br /> OWNER PHONE: OWNER EMAIL:
<br /> • ♦ ITV • •r ... �(• ..Ir..i `Y r,.< • r M . i• ,.. r i r . ,.. a. . r 1 •.! r. I -r- . r . • • .... +1V r, •.. ,.• ♦, T'
<br /> CONTRACTOR NAME: ,tae . �iV�Tn/_�IirTld�
<br /> CONTRACTOR ADDRESS: srneer Po eOX 41, aa p
<br /> CITY lyVI!11.7&0 3TATEwr7 za,g7c2171
<br /> C�
<br /> CONTRACTOR PHONE:422' 4 6144 , ♦CONTRACTOR EMAIL: kit. H4 ImA'�J�C el W1 T'. CD/Y)
<br /> CONTRACTOR LIC.#(REQUIRED): agAi ,l �,3,. 140CITY OF EVERETT BUSINESS LIC.#(REQUIRED):
<br /> 014001.
<br /> . ,+rw•++++w��—I•w.+,nw•r.p-ur,e�+xr ew.QP�.r.w,..mm.,•.e....G.....a rNe ...1. -..r.,-..yrw.a••n.•••f Mhrf,.+wwM•u•w wawrw ww♦.+..a.•r,+rrw.w.rr..uwww.rk+ayryn .
<br /> PRIMARY CONTACT: 0 OWNER ill CONTRACTOR 0 OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: ZOIC-736--6544 `
<br /> Dg �15 £!.p b(i/ CONTACT EMAIL: DE I S.e..A.OkJ® Kl -orAf!T. .O1}1
<br /> AGREEMENT T hereby cantly that I have read and examined this application and know the same to be true and eared Ail provisions of laws and ordinances governing this
<br /> type 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 consfruclion, That 1 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 78.27 RCW and 298.200 WAC.
<br /> City ofEverett Official Use Only
<br /> FEE X41100
<br /> d
<br /> PERMIT#
<br /> 5- E lY)b'o — I72
<br /> OwnedAu orizedA.en Signature Date (Revised 10/12/2015)
<br />
|