Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: i007 5E GV4 re4A- VIVI\ uJ Qy (1 n l'i- <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED _❑//SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: )(COMMERCIAL <br /> USE OF BUILDING: CarnryiercA aA <br /> ELECTRICAL APPLICATIONINFORMATION <br /> CONTRACT PRICE OF WORK: $ 95 <br /> NUMBER OF DEVICES(if low voltage): I <br /> FIRE ALARM? I YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 1 n j1"q 11 C') La) j►r cL I S p lay <br /> CONTACT INFORMATION " <br /> OWNER NAME: TENANT NAME(If Commercial): j',i,�rjq, S �7t 10n Ce <br /> OWNER MAILING ADDRESS: sTREET (3.2 I l eZa <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: 3'>°T 315y-is <br /> CONTRACTOR ADDRESS: sTREET ]I&J'1))0)-hell-Eve re 1+ 1 h F0Z3 <br /> CIIY friI 1) ni -eIL. STATE (kip zip q o12 <br /> CONTRACTOR PHONE: 4-125,33().01/06 CONTRACTOR EMAIL: J))7 511,r . 1);Ceiv <br /> CONTRACTOR UC.#(REQUIRED): (34 3I 51 Si 50 f)Q CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0551 O'/ <br /> PRIMARY CONTACT: ❑OWNER /IKCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: /42,5'.3y, 43)(0Q • <br /> Fr ni< CONTACT EMAIL: <br /> bb-VS/ ha�nisi,•co <br /> / PERMIT# <br /> EISO°1 <br /> 411,11!eA0 4" qx1 ..1,6 <br /> 4GREEME :I hereby ce that I have =:d and axe - ad this application and know the same to be true and correct. All provisions of laws and ordinances governing this type <br /> of work wil be complet=.whether sped d-• erein or .t. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or <br /> boa!law -. Latin• ••nstruction or the perf. . -:of construction. That I am authorized by the owner of this property to perforin the work for which application is made and! <br /> Dwvit)r - wenn/8.27 RCW and 296.200 WAC. Date .(Revised 912312016) <br />