|
'NIP ELECTRICAL 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@everettvmgov 1 www.everettwa.gov/perrnits
<br /> ate;
<br /> , & '.�vvnm�4�rck 1 ,. A" 1. �y ?L. „x„,,, j� „,,,-,;,,e„ ,,, ;,,,,,,-.,:„,e.:4,,,
<br /> PROJECT ADDRESS: LAI- • k 'mssv,k,f2,4-e, ao
<br /> BUILDING AREA(if residential,new construction,remodel,or addition)_ t''a. SF
<br /> BUILDING TYPE:1i SFR-DETACHED 0 SFR ATTACHED D DIP EX I MULTI- ILY-#OF UNITS: CI COMMERCIAL
<br /> USE OF BUILDING: t c&op ky.T.
<br /> •
<br /> e. ° � �� ss� �,.'4''y.;• � � y � � �„„•,°,„,.. s � � � ur> �
<br /> CONTRACT PRICE OF WORK:$
<br /> NUMBER OF DEVICES(If low voltage): -.- ”"
<br /> FIRE ALARM? 0 YES 0 NO
<br /> ASSOCIATED BUILDING PERMIT#(if applicable):
<br /> DESCRIPTION OF WORK: t�O taie... c lrw.,l".s aria , A6 &if - •{ 3.
<br /> Gtrcutts
<br /> 0(yy�� J
<br /> OWNER NAME: ```Cott S TENANT NAME(If Commercial):
<br /> OWNER MAILING ADDRESS: sTREer 1 a 5C? G'• t'11 1-1
<br /> env WORAIVINIiit : STATE0f ap1(bD1
<br /> OWNER PHONE: I'2.5' (+0'• 1 tUi OWNER EMAIL
<br /> a �R
<br /> CONTRACTOR NAME: 1\ ‘0,N) et :c7i1.L1 Call LI-C.'`
<br /> CONTRACTOR ADDRESS: solEfr )5O1 Lk 51t°,)
<br /> Crrr LCAMWOOCtsTATE W(�k ZIPfit1-1-ii/.'"F
<br /> CONTRACTOR PHONE: ?5 3 • " ao ea,405493 tT 3 CONTRACTOR EMAIL: flV 6/o/1z/cal ;f.3)a IJJ,I 4 G pN
<br /> CONTRACTOR Lit.#REQU,R EDt l/ L4 eeL j t to P` CITY OF EVERETT i BUSINESS LING �- RED)
<br /> PRIMARY CONTACT: Cl OWNER CONTRACTOR C I OTHER(Please Spacify)_ `
<br /> _
<br /> CONTACT NAME: CONTACT PHONE: ) ' , • • . (Q'
<br /> CONTACT EMAIL: ntssetteciti GGCQ I at% ikiai I . (.DIA.,{
<br /> AGREEMENT::(hereby that t have read and examined this application and know the seine lobe true and correct. All proutsians of wsand ordinancasgoverning this type
<br /> of kadl be completed whetherspeci1ed herein ornot. The granting of a permit does not presume to Lthe authority to violate Or cancel the provisions:of any other state or
<br /> local taw regulating construction orthe performance of conshuction. That lam authorized'by the ovmer of this ptopertyto petfot m the work for whisch application is made and I
<br /> comply with the State Contractors Law 18.27 RCW and 206,200 WAC.
<br /> F
<br /> ^v� City of Everett Official Use Only
<br /> 410
<br /> /��;/'' r •;Af �" PERMIT#
<br /> a
<br /> ..._-• I611t41ti E J9lO
<br /> ff"
<br /> OwnerlA .+ or-.:•Agent.Sl,
<br /> (Revised018)
<br />
|