Laserfiche WebLink
ELECTRICALzil <br /> PERMIT APPLICATION t . <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (i' - PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 1f r / "" q t coy <br /> BUILDING AREA(if residentia new con$ruction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DET D 0 SFR-ATTACHED XDUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: pi x 8'� ' i f/ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ —t 0 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DES RIPTION OF WORK: <br /> ge <br /> r1b-1.- -76.-.. r Pfritiat) „F / i {. <br /> y CONTACT INFORMATION <br /> OWNER NAME: S N - {� TENANT NAME(If Commercial): <br /> � , <br /> OWNER MAILING ADDRESS: STREET � "� to c) � _ <br /> CITYblfalerr STATE Wim”i ZIP 6 *�1;;;�s,"' <br /> OWNER PHONE: ) 4 "T c _OWNER EMAIL: ,,VAI--De 2 <br /> ,0 _ r r . <br /> CONTRACTOR NAME: tit-� .' ', i'4- <br /> CONTRACTOR ADDRESS: STREET /5S?0 -- t:k0 ie+° - ' JVl <br /> jy, �$ <br /> a ry CITY A / , j t�^e^^ STATE "' ( 21P J 2. <br /> CONTRACTOR PHONE: 4L.- "-t "`7 i ciii, CONTRACTOR EMAIL: RVAAI R( t�-6)Cow zie ,-�f'f <br /> CONTRACTOR LIC.#(REQUIRED): tk 1b -_• CITY OF EVERETT BUSINESS LIC.#(REQUIRED): �-f <br /> a. <br /> PRIMARY CONTACT: ❑OWNER )CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: r f'�.4t.,)) l CONTACT PHONE: ��^ ' 'l' ', - / 3 ' <br /> i it c I, CONTACT EMAIL: ' �a ,, dece " '' -• ,-e <br /> AGREEMENT:I hereby certify tha 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 ROW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> I-lids' E Iot- lo <br /> OwnerrAAuthorized Agent Signature Date (Revised 9/23/2016) <br />