1411 73RD ST SE 2019-09-12 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: pip 7'.-d 5E BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: jSFR-DETACHED 0 SFR-ATTACHED ID DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: " 0Led `RIC; LIOP441 NW 0„N' CONTRACT PRICE OF WORK: $ ,pO NUMBER OF DEVICES (If low voltage): FIRE ALARM? ❑YES VNO ASSOCIATED BUILDING PERMIT#(if applicable): DFSCRIPTION O.EeWORK:--.14/014-C1-' r- .. OWNER NAME: *box ne ,r TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ! 7 ! 12"i j f S ' b CIN ,. STATE .S A ♦ ZIP 17Cf ..�+ OWNER PHONE: 7/ 921 OWNER EMAIL: „CONTRACTOR NAME: CYy\ I �f�. l(}C CONTRACTOR ADDRESS: STREET � I laroadt22,8 CITY „lieRe•1) STATE R^ ZIP ")j 201 CONTRACTOR PHONE: y, "1 $ i CONTRACTOR EMAIL: ! 'moi / .414 4,g 1 # Vti4 CC3ATRACTt3fZ�LTC,'#(REpUIRED): }t._ CITY OF EVERETT BUSINESS LIC.#(RECUIRED): t,y�Q_. _ PRIMARY CONTACT: 0 OWNER ,,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 5 a5a &C1.K1 I i? CONTACT EMAIL:: . Int=G .coon AGREEMENT:I hereby certify that f have read and examined(his application and know the same to be True end correct. All provisions of laws and ordinances governing this type of work will be completed whether speckled 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# k to. . r E i {)()- OP2-14 Owner/Authorized Agent SIgnature Data (Revised 9/23/2016)