Laserfiche WebLink
^00041P_ ELECTRICAL PERMIT APPLICATION <br /> • .. CITY OF EVERETT PERMIT SERVICES <br /> 8200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 J FAX 425-257-8857 I,(E)everetteps c@everettwa.goV I www.everettwagov/permits <br /> . . PR J CT SITE J$FORMATI® .. . <br /> J <br /> PROJECT ADDRESS: 1,9 <br /> f- w3 <br /> BUILDING AREA(if re Manila!,new•construction,rernodei,or addition) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED El OUP1 EX Cl MULTI-FAMILY-#OF UNITS: Cl COMMERCIAL <br /> USE OF BUILDIN <br /> ...17.1.5:; ',':::::,''',:i:-..:;:;,--'1' <br /> 'j.5„ ,. . . . ; .,E4 0.0 ,40P4C,�#'i'IDN I$I.QR0tA,` '•1tai .. .4:• <br /> CONTRACT PRICE OF WORK:$ f <br /> • NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? El YES El NO <br /> ASSOCIATED BUILDING PERMIT#Of applicable): <br /> DESCRIPTION-OF WORK: IJP- /4//4l 1e"l- b 1t d 2 . ,q, <br /> Y _ <br /> 5. <br /> CONTACT INFORMATt. K+i' .. , <br /> t <br /> OWNER NAME: /* /)(--7A Iti(f TENANTj ME(if Commercial): <br /> OWNER MAILING ADDRESS: slam. ``JJ�.��✓.�°�ar�7 f ,�� �y <br /> MY Z.✓4` STATE 4.x"4 0/3 <br /> OWNER PHONE: ' {}u OWNER EMAIL: <br /> t. . .. M <br /> CONTRACTOR NAME: . L / ' . yL c + .. ..k <br /> CONTRACTOR ADDRESS: STREET 2(za 4 c..4 ( r <br /> CITY <br /> i, STATE 1.4.A a. ZIP C.-4-1 <br /> CONTRACTOR PHONE Z.S) G.- 3(t{" CONTRACTOR EMAIL: 1<e A&,455 et . cF"' +t...s <br /> CONTRACTOR LIC.,CREoutRED):EV., 1, 14fg- CITY OF EVERETT'BUSINESS LIC.#€REQUIRED) 7L <br /> PRIMARY CONTACT !OWNER �OIVTRAGTOR Q OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: (t-f`zc t Z z— 3 r <br /> CONTACT EMAIL: <br /> .AGREE1vMMNT.'Thereby nerdythatUhave read and examinedthisappllsation and know the same to he Prue and correoL All provisions°flaws end ordinances goventing this <br /> type ewe*Of be completed whether speedharein rrnof. The granting:ofa penult does not presume to glvsautherlly to violate orsanceithe.provisions of any other state or <br /> local law reguletmf canstrnotion or the pertolmance of construction That am a ilhortaedbythe owner of this property to perform the work for which application is made and I <br /> corn*wiThthe State Contnaclore Law 18.27RCWand.288,200 WAC: City of>wverettOflicZa!Use Only <br /> FEE <br /> 4? 1 4(3k <br /> • PERMIT_ # <br /> .z � i o/.0 001 <br /> ��/� .� Date (Revised 102/2015)Owner utnorized Agent Signature <br />