Laserfiche WebLink
EPs---Oe <br /> 4877 ELECTRICAL PERMIT APPLICATION /d SI/3 <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: .3000 ROc-kerEL.LC-y?„ J .R, <br /> BUILDING AREA(if residential,new construction,remodel,or addition) .360a SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTAC <br /> //1 I ED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS; COMMERCIAL <br /> USE OF BUILDING: *cio,i /J'+' /d/Nt 7 c e,ek '$ of-Rcb- 4 L <br /> . ' • ELECTRICAL APPLICATION INFORMATII 0:-':: .: • <br /> CONTRACT PRICE OF WORK:$ 5l 600 $V 1Id,N6 `, 7r,.1 j' ,i <br /> NUMBER OF DEVICES(if low voltage): 4 '73I To/ - 0 3 <br /> FIRE ALARM? BYES 0 NO 31141- <br /> ASSOCIATED BUILDING PERMIT#(if applicable): C il 3 <br /> DESCRIPTION OF WORK: ELEL7?V' k_ L/PA 1204i)E ' //1/ 71i ES E A 2, ; <br /> /YN Ali- Redd M1 O m O FP/ A/01'2�7 c 6/�1.e '7)E1II tf S7 4174 <br /> lei Le cli a A : 1 F/L10iecc ki / <br /> /VE 4i f22 7.GLQ�j 5 1 T rev 5 / M/Not2 L!5 bi7NG, a51v7Y/f.�(S 1 <br /> I.alw V'./f�a-b.� v c. 5 / <br /> CONTACT INFORMATIONt' <br /> OWNER NAME: 5 io h 1 /$/7 CbLLIJTENANT NAME(If Commercial : - , AL e- <br /> OWNER MAILING ADDRESS: STREET .364)6 7EFELLF2 AVe5 S D <br /> CITY fVO J + STATE Wk. zip 't2 / <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: ,Eve.4.1k4ealv POLI 1 :. 57 <br /> CONTRACTOR ADDRESS: STREET 3-4?-- /'�V <br /> - -rtid � � U- �V. <br /> i J <br /> CnY .3'1-- ."-Le--- <br /> STATE ZIP V'� <br /> 91 <br /> - <br /> CONTRACTOR PHONE: plCVgr CONTRACTOR EMAIL: /3 A T <br /> CONTRACTOR UC.#(REQUIRED): EerieiPS /57, 8 C CITY OF EVERETT BUSINESS UC.#(REQUIRED):46-117 <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR OTHER(Please Specify)S21 2Z +cmR <br /> CONTACT NAME: CONTACT PHONE: ,aDd•-'57'3..--724..s- <br /> AVM) <br /> '-'724.s <br /> AYM1 mc- 6#2 ti)C CONTACT EMAIL: gine13y2/f)0 g¢¢ilyt)5.A,rQr <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 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 1 <br /> comply with the State Contractors Law 18.27 RC W and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 0,, ,f)1144.74: 1 feC N_ ad-A0-"'o-"' / 7 E kz02-03 <br /> g <br /> riAutherized Agent Signature Date (Revised 9/23/2016) <br />