Laserfiche WebLink
ELECTRICAL PERMIT APCCATION <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: 29 ID c7,47-e ST. &vert,))- t'[-P t(")� <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: COMMERCIAL <br /> USE OF BUILDING: &Nu, _ /t4A k J Ver ��' tttttt <br /> ELECTRIC , L APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: ✓/z ,90,3-'— <br /> NUMBER OF DEVICES (if low voltage):/ <br /> FIRE ALARM? 0 YES It�NO <br /> ASSOCIATED BUILDING PERM #(if appf..ble): <br /> DESCRIPTIONRIOF WORK: 4,/ 2-, 2Odgito ZL/d vd/f 12 2 r � 6ovI LC42 1C"i9 <br /> 1. 64,-J Fa--loef-�Ii s , ©c,y;4-): ) ,•51c v,-, 4 <br /> �l1-AIA e' //ice P,�� <br /> CONTACT INFORMATION L - ONJ ceit-Crt,e_-• <br /> OWNER NAME: 4111 'cZ4 TENANT NAME(If Commercial): ,( $ like s. <br /> / <br /> OWNER MAILING ADDRESS: STREET 29/ Si -7-e_ ST�J CITYY� ,t,/t1'R' STATE 41/4 ZIP <br /> OWNER PHONE: 2 -S70 " dy8 OWNER EMAIL: '�- c-,-X 2 ive-S "Cia,'S V ci-, . CO"-) • <br /> CONTRACTOR NAME: ,c4(e £(e r,k- LL C <br /> CONTRACTOR ADDRESS: STREET Y` 0, 'o)( 26/3 _ <br /> 5...,016,...,,s4 �r CITY STATE 4•41/4-, JF'� ZIP :.29Q5 <br /> `1 <br /> CONTRACTOR PHONE: 92_.P27 3-,5529 CONTRACTOR EMAIL: ..1 yeeA`Lec-}/y 6.5-' '-0 400, CCO <br /> CONTRACTOR LIC.#(REQUIRED): F. redee6 G ? / ay. CITY OF EVERETT BUSINESS LIC.#(REQUIREI : _S-:..5-69(1, <br /> PRIMARY CONTACT: OWNER' /:a sNTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:7LC/ CONTACT PHONE: q2 S'- 27 3 .. r 3 2? <br /> `6 I Q r fes" CONTACT EMAIL: ( 74/4)%',Zd�^C�� :. . <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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> / PERMIT# <br /> E (`--(Dc , - ooh <br /> Owns/Authorized Agent Signature Date (Revised 9/23/2016) <br />