1827 72ND PL SE 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,SSIT.E INFORMATION PROJECT ADDRESS: Jg2 / / ir BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPESFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ,ELECTRICAL A IUCAlilbNgIPfl'ORIV,Ilk'tIoN CONTRACT PRICE OF WORK: $ 2-50 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 1!,< 0 ASSOCIATED BUILDING PERMIT# if a.plicable'i: DESCRIPTION OF WDRK: eSt5 '', ., ' _ ! coNtAdt.iwortiviAtioN OWNER NAME: '/ _4 4 / TENANT NAME(If Commercial OWNER MAILING ADDSS: STREET 11327 lam XI_ CITY,,.• �. _ STATE IN ��j ZIP i W 0 OWNER PHONE:.2.6 P °I J OWNER EMAIL: (4`' CONTRACTOR NAME: Y t c C CONTRACTOR ADDRESS: STREET Li I.' 0 t _ r� •...r.d . •r �� ^ STATE A A- %tP t"�('}20 CONTRACTOR PHONE: L,a5 �� CONTRACTOR EMAIL: • ' , .ei1g .i• ILO w iM CONTRACTOR LIC'.ift-ECaufRaDji C h n -1 an CITY OF EVERETT BUSINESS LIC.#(REQUIRED), 1 o a a PRIMARY CONTACT: 0 OWNER t CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: �� n CONTACT PHONE: (--Q55 5 OLTDO OCAO le CONTACT EMAIL: AGREEMENT:l hereby certify that 1 have read and examined this application end know the sametob>nd correct. All provisions ins� o� f laws andiices 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 stale 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. Gly of Everett Official Use Only PERMIT# cutv' 41-23.1g E c - 1c)( OwnertAuthorized Agent Signature Data (Revised 9/23/2016) ""�