Laserfiche WebLink
477 ELECTRICAL PERMIT APPLICATION <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 /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 5c03 t 01/11 and <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE:'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2B0 <br /> NUMBER OF DEVICES(if low voltage): I .4-4,4-cd- <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Md I akteF U fza...a-1--3 k /ah <br /> CONTACT INFORMATION <br /> OWNER NAME: Coj-ra'j ?B ec(Q.dn TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 1 X 3 I I lvi.t1 f1 C <br /> CITY � STATE \AM ZIP 7 ) 2E„J 3 <br /> OWNER PHONE:20(p 5n <br /> t0 lT7 . OWNER EMAIL: <br /> CONTRACTOR NAME: C-41V1, <br /> 4 � <br /> CONTRACTOR ADDRESS: STREET IIA1;y 2d Qoadl^L��.iJ+� <br /> CITY `(,4„)a) U STATE Vidk. ZIP T:8201 <br /> CONTRACTOR PHONE: 4 25 2$C( 095b CONTRACTOR EMAIL: Cleibbre. C )1k)2Qrr i e y'j.(a ( <br /> V <br /> CONTRACTOR LIC.#(REQUIRED): unite(Lt'Vl, Q'11 cQ, Ga CITY OF EVERETT BUSINESS LIC.#(REQUIRED): l Le 0 L U <br /> PRIMARY CONTACT: 0 OWNER �a-uONTRACTOR 0 OTHER(Please Specify) <br /> �CONTACT NAME:/�.�,� ( / CONTACT PHONE: 9 5 a� C)t �,, D J <br /> tW(Q''v+ r k/(,.Q `(IC' CONTACT EMAIL: (,X„Q,��Oce ►�C�M�+w %(t(I,G,, (8„ <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 lam 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 /> City of Everett Official Use Only <br /> PERMIT# <br /> [0 - 3- Eil \ D - l <br /> Owner/Authorized Agent1VlaoLX /I4ie- <br /> t Date (Revised 9/23/2016) <br />