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

ETT ttECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwagov I www.everettwagov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2532 57th St SW BUILDING AREA(if residential, new construction, remodel,or addition) House SF BUILDING TYPE: Ca SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Residential ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 700 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES NO ASSOCIATED BUILDING PERMIT# (if applicable) DESCRIPTION OF WORK: Add 1 30amp 240v AC circuit. CONTACT INFORMATION OWNER NAME:Thomas Powers TENANT NAME(If Commercial): OWNER MAILING ADDRESS: S'REST 2532 57th St SW Everett WA 98203 STA TE OWNER PHONE: 425 359 2552 OWNER EMAIL:tpowmuk@gmail.com CONTRACTOR NAME: Eastlake Electric CONTRACTOR ADDRESS: STREET 9805 NE 116th St PMB#7430 Kirkland WA 98034 C TY STATE Z'r CONTRACTOR PHONE: 206 605 4903 CONTRACTOR EMAIL: mike@eastlakeelectric.com CONTRACTOR LIC.#(REQUIRED): EASTLE*833LM CITY OF EVERETT BUSINESS LIC.CREQUIRED): 1/4,C PRIMARY CONTACT: 0 OWNER 2 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206 605 4903 Michael Proctor CONTACT EMAIL: mike@eastlakeelectric.com AGREEMENT.1 hereby certify that I have read and examined this application and know the same to be true and correct. Air 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 comply with the State Contractors Law 78.27 RCW arid 296,200 WAC. ij4r City of Everett Official Use Only „,- PERMIT# t--IN/ke E QV-) Owner/Authorized Agent Signature Date (Revised 9123/2016)