2524 57TH ST SW 2019-09-10 - Laserfiche WebLink

LIII 'IP Li!LECTRICAL PERMIT AIS LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE'INFORMATION PROJECT ADDRESS: 05A4 .3-7 Sr Std 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: ,cfi .: P - ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ " t b 0 O I NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES IyfNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ''''.5? Fscr ,D U va G,t,1 c v t t ,, cV-v IP A40t4ik q,lid0 ?AAA . • CONTACT,INFORMATION OWNER NAME: ,V1i'I\I Q i si.9 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREEr 01-94 7 74 y of Lv 9 CITY 6-Q e vz STATE (,9� .. ZIP 1� �Za 3 OWNER PHONE: 44.5 '391 ,9 610 OWNER EMAIL: CONTRACTOR NAME: FcJ\\ j p.e_c--tc TN-1y1,..._ 1 CONTRACTOR ADDRESS: STREET 9 8' ( p i DQ CITY Co e/`a STATE CO& qq ZIP / f Ze'3 t?f- CONTRACTOR PHONE: ( 3.3 --SV - q CONTRACTOR EMAIL:-c1K.s� TLv_ OesyN C CONTRACTOR LIC.#(REQUIRED):rwc-i-__61). ©Y9 K.G CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (1"4 PRIMARY CONTACT: 6❑OWNER . CONTRACTOR 5❑OTHER(Please Specify}��..�,_,.�~'Tw,y'V„~r�•�•-T�`~tlWw��^'p�v'_^`v`•�pp�,.v�l�`w'M CONTACT NAME: CONTACT PHONE: t.4"2-("-- ,3 3 0 ^- Syb 'DA-A..) 1 'a,(), CONTACT EMAIL: AGREEMENT:T hereby certiethd 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 RC W and 296.200 WAG. City of Everett Official Use Only FEE 4 top, PERMIT# 0 <fkz4 ) 8- l O(�- 1 Own- •uthorized Agent Si natu Date (Revised 10/12/2015)