Laserfiche WebLink
111 <br /> LECTRICAL PERMIT APICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 ( (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE;INFORMATION <br /> PROJECT ADDRESS: '3 1 f 7 0 A-4-ft <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: 0 COMMERCIAL <br /> USE OF BUILDING: �F n <br /> ELECT IC'AL APPLICATION INI=0RMATION.; <br /> CONTRACT PRICE OF WORK: <a oC. <br /> NUMBER OF DEVICES(if low •Itage): <br /> FIRE ALARM? 0 YES ! NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: P f a t:c , 'ILL(cr��'l,�o <br /> CONTACT INFORMATION <br /> OWNER NAME: IC..12SS TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 3)1y. f A/ch;J /� 9� <br /> �J p� CRY fn) [L./7 i L// STATE /A1/�C_. ZIP "�/`'(/I <br /> OWNER PHONE: 2,( 3301 1 l�j OWNER EMAIL: <br /> CONTRACTOR NAME: /Yt 4/0/J`iAt.-/F,J ring PiE <br /> CONTRACTOR ADDRESS: STREET 43t o <br /> CITYJ//�R/12/r STATE /�Jj ZIP 14/ <br /> CONTRACTOR PHONE: yJ f ,25 21(l / CONTRACTOR EMAIL: / 9 <br /> CONTRACTOR LIC.#(REQUIRED):,f L-//UJf /ylL/ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (h 6 31p <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) £L.-Lr i71117 <br /> CONTACT NAME: CONTACT PHONE: Vii 2yl .2 2 <br /> / 11 6- CONTACT EMAIL: <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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> f <br /> City of Everett Official Use Only <br /> et\\ PERMIT# <br /> `l E 9 �-24Z <br /> Owner/ <' •ri ed Agent Signature ate (Revised 9/23/2016) <br />