Laserfiche WebLink
iLECCTRiCAL PER 0 <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 J www.everettwa.gov/permits <br /> PROJECT ADDRESS: SO 1/ GIG.0.,,+ylot:1/4Y+' 'Eve reht, tea, -crao3 <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: I&COMMERCIAL <br /> USE OF BUILDING: . <br /> - <br /> .. •IB1�1�6"1f:'"MAL AlF PLq�A`>I'lf®@� O1�IFOI�V�ASi'0@1R9 � :: . � ::::. ..:: .. , : . �• �:�; •:• ::�: <br /> CONTRACT PRICE OF WORK:$ /50O <br /> NUMBER OF DEVICES(if low voltage):- <br /> FIRE ALARM? ❑YES IN NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 1,v5&' 1_.! yo I "P 2y' 5p`,4 a.wl;i' '7i ()c,ff*SS <br /> .,- ..-. ::00040:.#0164.00-441100.-.:.;1' <br /> .r. - .... <br /> OWNER NAME: Ck4.(6ivy0 ?rocks5,I I4 (e, ve LLL TENANTJNAME(If Commercial): W`Moio $'f C(eAtaf7c $ <br /> OWNER MAILING ADDRESS: STREET C()(',/]_ CElCidC,1„/ur <br /> CITYe UPiCG ti STATE _ W 6%-._ ZIP e O l o <br /> OWNER PHONE: p OWNER EMAIL: D <br /> CONTRACTOR NAME: jji sf9( )electrical (04-Ri.c cud �tSfQ � <br /> CONTRACTOR ADDRESS: STREET ` 209 Ca• .f `Z `1/¢'. <br /> CITY LL J!G V ^=: S STATE Ctia ZIP a 'S� C <br /> CONTRACTOR PHONE: y GO f6( 00// CONTRACTOR EMAIL: Ms S is r,17-;(,,1 43J <br /> �� 1 CITY OF EVERETT BUSINESS LIC.#REQUIRED <br /> CONTRACTOR LIC.#(REQUIRED): �L�JId'i a> c tiS I ( ) S ►"CO <br /> PRIMARY CONTACT: ❑OWNER IS CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 3/ �'0 q f 0011 / <br /> 'Yak Set.) CONTACT EMAIL: 6IVres j, i d Ile cam <br /> AGREEMENT:T hereby certify that!have read and examined this application and know the same to be true and correct All provisions of laws anoilordinances 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 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 WAG. <br /> City of Everett Official Use Only <br /> FEE <br /> , t?,/(1 <br /> / I <br /> PERMIT# <br /> 7-6' E 1BO <br /> Owne"rlAuthorizedAgentSignature Date (Revised 10/12/2015) <br />