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ELECTRICAL PERMIT APPLICATION
<br /> CITY OF EVERETT PERMIT SERVICES
<br /> 3200 CEDAR STREET,EVERETT,WA 98201
<br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps©everettwa.gov I www.everettwa.gov/permits
<br /> ,' -' - -.4.',..' - ' ,A".;-'-` 4 4E0r..?-77477.5T. ' • 46
<br /> PROJECT ADDRESS 7J20 et.4
<br /> 113L/ILDING AREA(If residential,new construction,remodel,or addition ' SF
<br /> BUILDING TYPE: JR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL
<br /> USE OF BUILDING:
<br /> tV,;14.11:.e17:"1/4-',7;,7:1: -V:14-:".J.W.17t,:i;‘.?'14,.7.-,i,'...:,!,..C.77: 34-fLZIETZ;l• litT4., 1,477ta:Z-L.41-iti-Viir.,MtN3'074:',‘",:-:e',-,
<br /> CI)NTRACT PRICE OF WORK: $ • , .(,'D °°
<br /> NUMBER OF DEVICES If low voltage
<br /> FIRE ALARM? DYES . 0
<br /> otoNfatis,
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<br /> ASSOCIATED BUILDING PERMIT,#fit tip oabie):
<br /> DI- ,... - ek a A e•
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<br /> -7,7';"4..-,lel.f`,"-:, .1,,,.‘,„%..• TW,1,,s' ''-,?. ,4;'\`,.Kt',.:',.,l• '•:-,:-.1r,a-off,7 IfraTIT'ffrTf.717,7r77,T,TrIT74*--,-7,,... .;,' VT- '"'
<br /> , ‘ '-: - ' •,j4t10?! 1-I,t„a),L.4.14,0L44:,t tt.61414,- , ,1""' ' '.
<br /> OWNER'NAME: r- r *or bp(1) TENANT NAMES If Commercial./
<br /> OWNER MAILING ADD .--z S4„,
<br /> ...... TREET 40 . . .,
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<br /> OWNERRHONE: 4, 0. OWNER EMAIL:
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<br /> c()NTRAcrolt'NAME:
<br /> CONTRACTOR ADDRESS STREET tt415 'Taroadv.Kttz
<br /> OITV •:.a,_:/ . atATE , A 20
<br /> CONTRACTOR PHONE 0:0 eil tit;704 6 CONTRACTOR emAtt4, it ',Ii0 igA -. ,i* A.,:oN* if c 4 tryt
<br /> ,..._. , _ ,,,
<br /> wti 1 mo i Lt.(LIC.ii0 OUISE0):-.Unt le. - '6' on CITY OF EVERETT BUSINESS UG MORE . r .:-- ------ -
<br /> PRIMARY CONTACT: DOWNER '14:CONTRACTOR 0 OTHER(Please Specify) '
<br /> • '
<br /> CONTACT NAME: CONTACT PHONE.
<br /> ' 4000 35ct D4350 '
<br /> ,
<br /> e-2 CONTACT-EMAIL: C14;Ibije ' •., ,
<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 lows 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(he 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 /> - -
<br /> PERMIT#
<br /> tet7)24., 12.
<br /> E
<br /> Ownor/Aulttorfami Agent Stigiature - Date (Revised 9/23/2016) '
<br />
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