Laserfiche WebLink
LLECTRICAL PERMIT APPLICATION <br /> „m CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov i www.everettwa.gov/permits <br /> PROJECT SITE IN 4ATIOId <br /> PROJECT ADDRESS: /(, 3 2 /-to t V1 <br /> BUILDING AREA(if residential,new construction,remodel, or addition) LAV SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 D PLEX ❑ I LTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: Rms. .D-m"r"pt.c-Ii- 0 `CA, .-- <br /> ELECTRICAL AP , <br /> PLICATION INFORMATION <br /> oo <br /> CONTRACT PRICE OF WORK:$ (A to6. <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES IikNO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: u.)-ti\.l_ 0 t 't-N {lap CIprR.iNt2 CAS(fsta 1-KS1S1-11.16 <br /> 2-.NNl0 i z.av �tA-cLLi( t'0C„t--cx` 1Jta: to- Recrv-► 6— uClea- 2 SWcra-$1- . <br /> CONTACT INFORMATION <br /> OWNER NAME: 5313 S fO tf L TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /CO 3 .. Hoy r /f lig <br /> CITY /_+V ra/-is 7' STATE LA/Ar. ZIP 7 9"a-45 I <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: H e ('(1•-.1(y' 1L d (jV C_ <br /> CONTRACTOR ADDRESS: STREET 3 R" 6!`✓-"� f- Rf S/ 1a <br /> cITY V FSR E? STATE VO' ��l ZIP ?Q I <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: NI C.(,-)1.91 / aLc-c(fit @.' t r.4 mc..._ <br /> CONTRACTOR LIC.#(REQUIRED): Met.(1J sC003 tar CITY OF EVERETT BUSINESS LIC.#(REQUIRED):tri$3°f O <br /> PRIMARY CONTACT: 0 OWNER A CONTRACTOR 0 OTHER(Please Specify) . <br /> CONTACT NAME: CONTACT PHONE: y 7,g 3 0„,,,q- 0(.93 <br /> ILA Itex--___ tAC t,t t- t CONTACT EMAIL: S(I tqa <br /> AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. Ail 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 l 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 I <br /> PERMIT# <br /> E2.V00-- \2.-(4 <br /> O r/Aut rized Agent fii n re Date (Revised 10/92/2095) <br />