Laserfiche WebLink
1111P�-- I—CT ICA PERMIT ,API= ATJON <br /> POA r, _ 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: ' Oe' r <br /> BUILDING AREA(if residential,new construction,remodel,or addition),/i'/4eCM ( �M SF • <br /> BUILDING TYPE:%SFR-DETACHED SFR-ATTACHED <br /> ❑ DDUPLEX 0 MULTI-FAMILY-#OF c `O_�T-7ZUNITS: <br /> _ y�G ❑COMMERCIAL <br /> USE OF BUILDING: �dC�t' COt'tilil C//.t c y �p 74gce. �I SS/ �4g es <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 43-404 /1iLCC }C eh/tee-74 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES F NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: KKephc.e 1 14.f,,,xr-eS �L-4 e4 <br /> �ro fies l �f• rece1, 7'f <br /> CONTACT INFORMATION <br /> OWNER NAME: 1 -eve ee,//tdLl�iGr Q �e TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET(Z217;CI-Jei ' <br /> ern'"i/ve STATE V(/- ZIP £73 <br /> ( <br /> OWNER PHONE:gt�Z.S—337–F0,22,7 OWNER EMAIL: 5/ ,Ol1 s e(rtere7?c eNecPU. <br /> CONTRACTOR NAME: (/ <br /> CONTRACTOR ADDRESS: STREET <br /> CITY L_-‘ 87p3 V� ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: �� J! <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQ IR :OECT4.10 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT:T 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 <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 WAC <br /> 490 2 <br /> I" aeStlOh s"C ��Dh -' 4;C6-1(' 1 A`U is <br /> City of Everett Official Use Only <br /> O <br /> FEE <br /> • <br /> &a, eL2c�i ca/Sv��'rvc ° <br /> � vP" F PERMIT#E q-OL- <br /> O <br /> Sc' <br /> Owner/Authorized Agent Signature/ Date (Revised 10/12/2015) <br />