611 54TH ST SW 2019-09-10 - Laserfiche WebLink

#AP",-- ELECTRICAL PERMIT APPLICATION IOi ; -, 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 1 www.everettwa.gov/permits -; ; u tta1 : --iiiiii4 w,,. »±, *s.... '�.,. z +*T00 .'. :411��•�^w i'..., PROJECT ADDRESS: 611 54th Si SW BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Residential rlitt::: :•-Riallk:;.. CONTRACT PRICE OF WORK: $ 0 , J \)T�il(l•I (2 NUMBER OF DEVICES (if low voltage): '�[ (� FIRE ALARM? 0 YES ® NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: installation of 120v 30amp circuit breaker in panel, RV power stand with two breakers (30a 120v and 15a 120v), and two outlets, in parking area, and wiring between them CONTACT FQlWATION OWNER NAME:Randy Chapman TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 611 54th St SW cry Everett STATE WA ZIP 98203 OWNER PHONE: 206-335-5298 OWNER EMAIL:WilbUr4321@gmail.com CONTRACTOR NAME: N/A CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Randy Chapman CONTACT PHONE: 206-335-5298 CONTACT EMAIL:�nfilhi itr4321(lnmail.rnt°n I i 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 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. Oily of Everett Official Use Only PERMIT# !, 129/2018 E 1 (' )C(c- re,, � Owner/Authorized Agent Signature Date (Revised 9/23/2016)