6021 EAST DR 2019-09-04 - Laserfiche WebLink

1LECTRICAL PERMIT APPLICATION I�►' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits 4 `2 .N __ _ ., g; SOS\. A PROJECT ADDRESS: 12021 -E OS± 1J1 \/ t(-f F 1Allot 01%2_097 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED `I9SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: e2f I I VI ) 1�1, ,v. ,. • �k CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 13PNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -.. 011M p VV YV `tV Q C1�(AA, 1 Dv t) , ' D vvi p Ci1�t'it�tc-f- elc-t-e4nSion -for or>cr- s ourtioob.i ..y OWNER NAME: V arneS Ofd0\+ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (Q 02-I -&°St. SDP-CITY CITY 'ej�',ti/ STATE Ppp 7 ZIP9 Q20-3 OWNER PHONE: /R- OWNER EMAIL: N/A- CONTRACTOR NAME: I Vl 1-4-tm&e. CONTRACTOR ADDRESS: STREET 1GJ'�JQ° t vi- I'ib - SE. A� CITY La�v v c^1 l/r en s STATE V V 1/k ZIP Qa2 C CONTRACTOR PHONE:x}25 1(QO a2-0CONTRACTOR EMAIL: IVlepe rvr)l_t_S &.3I'Y\GI,I (,a.)rn CONTRACTOR LIC.#(REQUIRED): L N H(/tz S"I( 2-(e7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: [ CONTACT PHONE:421t 0 vZ02j CONTACT EMAIL: t h,eK (-t-s �t t, 0 -v-1 AGREEMENT.*I hereby certify that I have read and examined this application and know the same to be true and correct. All provisids of laws and ordinances governing this 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 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Officiel Use Only i PERMIT# Aep ( EI9 * i Owner/ uthorized ge lr ignature r ate (Revised 9/23/2016)