Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> �e CITY OF EVERETT PERMIT SERVICES <br /> voilifiripe <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 E (E)everetteps©everettwa.gov I www.everettwa.gov/permits <br /> " --ZPROj#Ctart 1 F '13014 oI .. ... ., + <br /> PROJECT ADDRESS: 100 - orr _ <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: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> 'A S fits:r ; ! fns z_¢ A �'p,g� p] <br /> q< (yam <br /> CONTRACT PRICE OF WORK: $__. <br /> (7 a' <br /> NUMBER OF DEVICES If low votta.e <br /> FIRE ALARM? D YES 0 0 <br /> ASSOCIATED BUILDING PERMIT; if applicable): <br /> OBICRIPTIOUOFi ®wKL.___m jJ11 tlJ }. t9 r r _!.r r <br /> OWNER NAME ► ,.p 1/14 C TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET w 44 14tAtO : <br /> cm' , ,wig" <br /> aTAT _ IIV <br /> "' # 2O 6 <br /> OWNER PHONE <br /> r OWNER EMAIL: <br /> CONTRACTOR NAME; At A Y <br /> CONTRACTORGJ DDRESS: STREET ( Kit e .vr <br /> carr { t�,� <br /> 6TATE YY ZIP II 4 <br /> ieRer <br /> CONTRACTOR PHONE: « <br /> 195cZ JCONTRACTOR EMAIL: <br /> coNTRAcTonua.3 (REQUIRED) 0 ' illi ,a 4 <br /> CITY-QF EVERETT BUSINESS LIC,#(REQUIRED, itot <br /> Iiti <br /> PRIMARY CONTACT: 0 OWNER .CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 11Q000, 90i c/7040 <br /> Ve,,Ialale CONTACT EMAIL ` ` ; ' <br /> AGREEMENT I hereby certify that i have read and examined this application end 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!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 /> . h9� E t b oLi- 1 bt?) <br /> Owner/Authorized Agent Signature <br /> Date <br /> (Revised 9/23/2016) <br />