2532 57TH ST SW 2019-09-10 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION __ 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 www.everettwa.gov/permits pROJECT.SiTE INFORMATION PROJECT ADDRESS: 3 2 5-7 � _SN I BUILDING AREA Of residential,new construction,remodel,or addition) SF T BUILDING TYPE: ® SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL AP L1CJ TIO1 INNSRMi `IOt+IC CONTRACT PRICE OF WORK: $ 2_50 .°'O NUMBER OF DEVICES (If low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable); DESCRIPIIOILOEr ORK: _—. =CoNTACT 1MroRMA`t ION OWNER NAME: i? A 5 17noer r., TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 9.,5 32 5? SR- CrtY s $TATE WA `_l .-a-.♦<.+t Lip OWNER PHONE: LiQs5 351 2-5-5 OWNER EMAIL: CONTRACTOR NAME: A CONTRACTOR ADDRESS: STREET I Li 15 OL UC CITY "�"tl s _ STATE .pP �� 2 GC/7 CONTRACTOR PHONE: 1-05 Cxiq CONTRACTOR EMAIL: dek,te CFY)h. 9 r t r i CtTN IRACTOR LIC-#(REOUi rn) CY Ev -te[d1..._.._ CITY Q__EVEREWTT BUSINESS LIC.#(REQUIRED}: PRIMARY CONTACT: 0 OWNER faCONTRACTOR 0 OTHER(Please Specify). CONTACT NAME: CONTACT PHONE: f 5 3541 b '042L+e CONTACT EMAIL C • Yi" Lt") COIM AGREEMENT:f 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!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 Official Use Only PERMIT# Pe,..b4Le,4 t -icy I , E %,bg - < < 2 Owner/Authorized Agent Signature Date (Revised 9/23/2016)