Laserfiche WebLink
04:77- EL1TRICAL PERMIT APPLOATION <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 /> r <br /> PROJECT ADDRESS: 4 7,27- tt,a l 4# 5 <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: 'COMMERCIAL <br /> USE OF BUILDING: r km,Sti,rlj, J i V‘1 L <br /> � t �c�r.a p arlN NFoilnT <br /> �1*° r`.�.�A", a`����sf ,s._:���" ,..,...:��ss>.��s�,av�;�r,,•u,�-��.�,,,�r�,u s>ar�w �s� "�Via„. 9.�w�� , �' <br /> CONTRACT PRICE OF WORK:$ 11, L90 L2 <br /> NUMBER OF DEVICES (if low voltage): lZ <br /> FIRE ALARM? `IA YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): cfc.( E. ( t,Z-t2`1Z_ <br /> DESCRIPTION OF WORK: fleLme, t psi FI Pty <br /> ef, <br /> .„ P � Yi � 2 /. r-4. <br /> ti f ��� TION � � � - <br /> OWNER NAME: TENANT NAME(If Commercial): tasB-ray ' 41-4.9m,i c. dih tL. <br /> OWNER MAILING ADDRESS: STREET 7C C7 j .. fes/ +�j/� (/�Q <br /> CITY al/11060W1-s-�i( STATE (4 f4 ZIP L V 01.9t, <br /> OWNER PHONE: 4z-3"Z.:7- i�,yt-� OWNER EMAIL: <br /> CONTRACTOR NAME: 0(y/iWL9 fC 54.414.4%btf-y <br /> CONTRACTOR ADDRESS: STREET _ (9 .Tj d' 3.3 59 <br /> CITY iliA.ylA.(VI,GwC4-k311A STATE LLTIA <br /> ZIP Z-2-3 <br /> CONTRACTOR PHONE: 3(f9 //C?S-e8" CONTRACTOR EMAIL: Tit 1.-1-1.4%,...0 0Iyutp h- , Co <br /> CONTRACTOR LIC.#(REQUIRED): (7/yn,p 5 t;o Q Z to f CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 03 got( <br /> PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify) <br /> CONT CT NAME: CONTACT PHONE:4 v '&O- (25-_`t'5 <br /> Irk(C-1J:�, y,, ysezi) CONTACT EMAIL:int 444442er2t 4,0IIC> G4.44,,, c et,147-- <br /> AGREEMENT:I hereby certify that I 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 /> 3 / E - - `tl <br /> Owner/Authorized Agent Si ature Date (Revised 9/23/2016) <br /> II �J4 <br />