2121 74TH 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 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE:INFORMATION PROJECT ADDRESS: 212,1 114441 5j S BUILDING AREA(If residential, new construction,remodel,or addition) SF BUILDING TYPE:"SFRDETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL t USE OF BUILDING: ELECTII ICAL,yAPpile 1'Ci+C NeiNFORIWAtION CONTRACT PRICE OF WORK: $ ZSR , NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES '›KNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIP.TION_OF .WORK:_ 1,145L� c*t ss h. x.t /y r cOI TAT INF{RMATI9N OWNER NAME: V IC-CA/ --e>41:>" TENANT NAME If Commercial OWNER MAILING ADDRESS: STREET 212 i 74441 ,S St J1 1((� CfTY 6i rP.r STATE j) ZIP t V 2.o& OWNER PHONE: 425 g7c) 4757 OWNER EMAIL: CONTRACTOR NAME: ryokA L. CONTRACTOR ADDRESS: STREET !`t 1.5 W® qd/Q"('�'",�� L4 "� CITY ♦..wi.w < , STATE GV" A CONTRACTOR PHONE: /-05-c?5qocHo CONTRACTOR EMAIL: deie �. rei CONTRACTOR L1C.#(REQURED):C.Ythe.401Z-77 ' -- JITY OF EVERETT BUSINESS LIC #(REQUIRED): 1 WO .. PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �--f a5 35q (e CONTACT EMAIL: d,r - I/Kati 020 AGREEMENT,I hereby certify ihat1 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 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 2SiE E 2_3 Owner/Authorized Agent Signature r Date (Revised 9/23/2016)