Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 FAX 425-257-8857 f (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT.SITE INFORMATION <br /> PROJECT ADDRESS: 2\ 0 r <br /> BUILDING AREA(if residential, new construction, remodel,or addition) <br /> SF <br /> 3UILDIN3 TYPE: R-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY- OF UNITS <br /> ❑COMMERCIAL <br /> USE OF BUILDING: <br /> J <br /> ELECTRi1~AL APP.L tCATII NNF;ORMAtION <br /> CONTRACT PRICE OF WORK: $ 2.so <br /> NUMBER OF DEVICES(if low voltee): <br /> FIRE ALARM? D YES ❑ NO <br /> ASSOCIATED BUILDING PERMIT#{if applicable): <br /> DESGESI XION L7F._VVOF <br /> 'CO 1 Ad1 IN[r oRmoio <br /> OWNER NAME: 0 A • TENANT NAME If Commercial): <br /> OWNER MAILING ADDRESS: STREET a► IL la CAA* 111"d'411111111111111.111111011111111.111 <br /> • <br /> CITYgJ .f.. ,� , <br /> STATE Vv np <br /> OWNER PHONE: - OWNER EMAIL: <br /> CONTRACTOR NAME: LIZ...a' <br /> CONTRACTOR ADDRESS:: SrRE'_r I Woad-id,' <br /> CITY ''} <br /> _ '�"'tl-" 'A STATE A . ZIP c. 20 1 -. <br /> CONTRACTOR PHONE: wi +r,(,—`"1 07e • <br /> 1r► CONTRACTOR EMAIL: t '4f;� � is if'l � � � 014 <br /> CONTRACTOR CItT#tlFtt_CIUiRcf?70*TEIlr <br /> �4 CITY OF EVERETT BUSINESS LIC.#(rtECIUIFtED: * <br /> PRIMARY CONTACT: 0 OWNER Fai: CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: _ <br /> CONTACT PHONE: ^)� 35q <br /> ),,0 <br /> AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of Jews 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 I <br /> comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> ter,}('J , 1 ''. PERMIT# <br /> 0 I 16 <br /> OwneriAutharfzed Agent 5ignature I. I <br /> Date <br /> (Revised 9123/2016) <br />