Laserfiche WebLink
/' ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 ( FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwagovfperrrlits <br /> PROJECT SITE:INFORIIAATION. <br /> PROJECT ADDRESS: 3 1 ' 5T S�= <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX CI MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: 5ta`f.°vc41' <br /> CTRIC L APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 00 . . <br /> NUMBER OF DEVICES(if low volt ge): <br /> FIRE ALARM? 0 YES 0 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Pc d Ivy ct . -S, s ou i *fa 1A` 'e <br /> .0 I ec bier t.' .t.. 'ss0 .rc t <br /> CONTACT INFORMATION <br /> OWNER NAME: � Y 1\4'. TENANT NAME(If Commercial); <br /> OWNER MAILING ADDRESS: STREET t3% — S k1 S J -�p <br /> CITY �-s4 - ,p STATE l.t�.i ZIP jtf d <br /> OWNER PHONE: -PS" L '-k '-A( OWNER EMAIL: <br /> CONTRACTOR NAME; I ct... -tki3( .Ir " 'b <br /> CONTRACTOR ADDRESS: STREET ' ) x <br /> CITY y\Ytti.Yr( STATE ztP 1.r• <br /> CONTRACTOR PHONE:qZ(S.----7-1SY Ct t 44 !CONTRACTOR EMAIL: `z ,t tnet 1 r 'Fr ct.( <br /> CONTRACTOR LIC.#(REQUIRED): T4.k,. . 1 a talk CITY OF EVERETT BUSINESS LIC.#(REQLIRE10,. 441,2 <br /> PRIMARY CONTACT:. ❑OWNER Iir>CONTRACTOR Cl OTHER(Please Specify) •, <br /> CONTACT NAME: CONTACT PHONE: � - '— i— t { <br /> f l , } <br /> � Y V'...�"�►.- CONTACT EMAIL: ,.„,e-•1 ,Y`- C'.. rein!I <br /> AGREEMENT'I hereby certify that t have read and examined this application and know the same to be true and co t. All provisions ofiaty d ordinances governing this type <br /> of work will be completed•whether specified herein or not. The granting of a permit doevs 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 RC and 296:200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 1. <br /> *.4.44.4.4 eikararailLA k) <br /> frif <br /> E '3O <br /> a er/Authori ' 'gent Signature Date (Revised 9123/2016) <br />