Laserfiche WebLink
,10111P-1--,--t,_ 4 ELECTRICAL PERMIIT ! t*UCA 19 I©N <br /> i. fr� r„ <br /> , r CITY OF EVERETT PERMIT SERVICES <br /> , 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 l FAX 425-257-8857 I (E) everetteps@everettwagov l www.everettwa.gov/permits <br /> .- ) i"O AI C `I`Oli`�!''f .t,:#0€ ibl [( l( ' . <br /> PROJECT ADDRESS: N'2O tekeLl / xet- 'e rg2-/ 1 <br /> BUILDING AREA(if residential,new construction,remodel, or addition) SF i/ d <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 2I"COMMERCIAL <br /> ic /4-;--;USE OF BUILDING: ( r Me �C f , gp":,2 +t.,,./c,,'(• ,1 <br /> - 11��gg 1I��WW:••�� gg66aa 1I p� g �A y� p ggR�,,9e22-- I�A��p-,.!v�pp <br /> -.: •L.LEG RIO S LS ' II P Il�ATI10'' IINIFOIRMAIt IdJ r <br /> CONTRACT PRICE OF WORK:$ 'etr)e <br /> NUMBER OF DEVICES(if low voltage):, (1() <br /> FIRE ALARM? LYES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if appllicablle)© <br /> DESCRIPTION OF WORK: 4$/1/Sc�-ec ,i'1 O/?/(`EOd(1--e 0? FC 7:_e 4-(0:4:47,./ <br /> _ <br /> _ •; ... i,;.'.:,:CSN`d'AC71:40.0RM¢#'i"1ON..:..: . <br /> �: ../_:_-_,:':: <br /> - _ - <br /> ,: _- ._ . - <br /> OWNER NAME: I�_ 010 (J� �?� TENANT NAME(If Commercial): ami.A.)/q C <br /> / <br /> OWNER MAILING ADDRESS: STREET j 1 at) Q_�i4-tic Erie ' kl <br /> Fue,/L -{1- CITY ( <br /> , j�y�NER EMAILSTATE r t/a( ZIP 221 <br /> OWNER PHONEaI `�.. --` C7© ., <br /> p. f 45W : . ./'�... ... , . <br /> CONTRACTOR NAME: /1J r-6(.,:3 1 <br /> -- <br /> CONTRACTOR ADDRESS: STREET /—c�-2( Cte ,r-N I _Set— <br /> . <br /> , s // �q <br /> CITY ?-- l/.J�A `V-' STATE `� /` - ZIP Q\9)2V 1, <br /> CONTRACTOR PHONE: /{25-232 CR cf er CONTRACTOR EMAIL: , 4 kOwa f` f-_,..Q/' ' u,5e(/L(61,-v r. <br /> CONTRACTOR LIC.#(REQUIRED)• r c� C�P q� D): 1 S E`"I. .{� <br /> . .A44 �T CITY OF EVERETT BUSINESS LIC SQUIRE <br /> PRIMARY CONTACT: Cl OWNER IR ONTRACTOR 0 OTHER(Please Specify) ? <br /> CONTACT NAME: CONTACT PHONE: G/a 2 3z Q q 7 <br /> . , .ri iii,) a f CONTACT EMAIL: 1C��31rca ,�.,a m <br /> �-� l�-aer�..�n/� � C�c`�G t co <br /> AGREEMENT T hereby certify that!have read and examined this application and know the same to be true and correct All precisions of laws and ordin noes 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 construction. That l am authorized by the owner of this property to perform the work for which application is made and! <br /> comply with the State Contractors Law 18.27 RCW and 296.205 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> ir. <br /> * 9 2_ . o <br /> PERMIT# <br /> I <br /> E a �1 (oi 30 <br /> Owner/Authorized Agent Signature Date (Revised 10/12/2015) <br /> �'4 <br />