Laserfiche WebLink
etu <br /> ELECTRICAL PERMIT AP ATION <br /> 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 1 www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT <br /> ADDRESS: �.� t 4 &`� �� ` t1 CA). }'r <br /> BUILDING AREA(if residential,new construction,remodel,or addition) al 7 Z SF <br /> BUILDING TYPE: $.SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: G,t„(a3,A <br /> La <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ \5 00 k t CCD 0 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Cg0(4.2 60 <br /> DESCRIPTION OF WORK: I r r- x R v -t c .e,,G,..e j <br /> opka. "'' l �'rR �' / y- c3 La . .*J r __ <br /> Gti g t. C cLfCQ -R- ArVI c N1, <br /> CONTACT INFORMATION <br /> OWNER NAME: 1\it TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREETa a� <br /> CITY E\/ y STATE lk ZIP 920.0. <br /> OWNER PHONE:(SO.'S')577—�vZ '�� OWNER EMAIL k��poj Ig C( ('J 4 o 1�r1� <br /> CONTRACTOR NAME:X ()tun r <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: %OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: l 60- fj 1� <br /> L - � P- _ CONTACT EMAIL: ,f..� --- Ow), 1cvl <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 /> i-41 ,r\vbj , <br /> 2 -7 tg E -- 3-S <br /> Owner/Authorized Agent Signature ate (Revised 9/23/2016) <br />