Laserfiche WebLink
4En- 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 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> H Y�' Q �Y <br /> v�. v.<:�:,. fi z -5fl_� --!-:,:;,.:„.:4., :::!:,-,,i,..,,.,,...4:,.'',,:,...;atw,.,- .,:,c„40,.p41- ` 1 ',411-'41'4,,;;''''''''''''' '..� .. <br /> PROJECT ADDRESS: 571 I.2, ! 37— b r, <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: )(SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> �' ' a r sib a4 �� yyg, ni ° <br /> v Mn t i' ,a�k �"( ¢iii .. 'i �' . <br /> �„.�'�a t,,. i�. rob� � i Qrz.�m�mw», u k Po :� � .. "Ja <br /> CONTRACT PRICE OF WORK: $ 4700- 0 CD <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: /f°1 3-ket.LL ft-e..w QCc4.4.: 4- .e-C l`/ 4il-..rjt-�,1_ <br /> 111#0NT*CTiIMF A <br /> OWNER NAME: .Q_i u TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 5 f� /c2., / S �Ot' a) Ain <br /> CITY l/a/v,tc STATE 4line ZIP 9v�{n <br /> ..g0.3 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: /11/ Ci , e e yn p <br /> CONTRACTOR ADDRESS: STREET / 6o/r/'••-8 Gk) /e,teg-/&_ i.iJ Paz i-r c /26 <br /> CITY S lectr/AJE STATE G+( ZIP Ter 77 <br /> CONTRACTOR PHONE: ,O6 --6 ---6,3?j.3 CONTRACTOR EMAIL: hC--!`k. OJ(c-(F-r1.e._l e_c_'(- tC'Ft^-13 ri.e_r, <br /> CONTRACTOR LIC.#(REQUIRED): p'(-(.Cil e7 - "f 4 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):OrjOC <br /> _. .. . <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR OTHER(Please Specify) (DIA—Le iikLtNt -e.c <br /> CONTACT NAMpE: CONTACT PHONE: — � 3—(4;333 <br /> �/t...I �-r CONTACT EMAIL: .-5/114- <br /> AGREEMENT: <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 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 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 /> 14., . C.... <br /> 91,9-a8 E V ISO -- Ok <br /> •wn• thorized Agent Signature Date (Revised 9/23/2016) <br />