Laserfiche WebLink
ELECTRICAL PERMIT APPLICATION <br /> IA' <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: sc(--;?-1, _5 <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 /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 4 kr-- <br /> NUMBER <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? ❑YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ii <br /> DESCRIPTIONtOF WORK: teC� � � ��� IA C exv-t CC�fidue <br /> ?e_ t ocla � �(J do i�,Se ekArl - unAer C A6 L 1 4 fA o1 1v--C Q. (4- I` cA c).) <br /> CONTACT INFORMATION. <br /> OWNER NAME: d\e‘ `k C '�, 14s TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: (2)(8, ,zI p_ ' r(;,-,);.‘,C, <br /> I �' <br /> CONTRACTOR ADDRESS: STREET '(3 >r (-14) P <br /> CITY Mail r' STATE IAA ZIP 91)2c- <br /> CONTRACTOR <br /> 1 /Cc- <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED)• CITY OF EVERETT BUSINESS LIC.#(REQUIRED):�.., j-`7/ <br /> PRiMARYCONTACT: LI] <br /> OWNERaCTRACT0R 0 OTHER(Please Specify) <br /> CONTACT NAME: (I CONTACT PHONE: ~ t-f'3'- `s'?3 2 <br /> ° P.cuk >clAv-► <06"-- CONTACT EMAIL: C cD ct ScA eJ ec{ve G @ 4 l i,e' CO$1 <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 t 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 /> FEE 11 <br /> PERMIT# <br /> I 11144 <br /> c 1?2) <br /> Owne :utho I •d :gent Si. ture Date (Revised 90/9212095) <br />