11806 25TH AVE SE 2019-09-18 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION ^� CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 ( FAX 425-257-8857 f (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: AO O 6- 20) 4( 0 BUILDING AREA(Iffr�residential,new construction,remodel,or addition) SF ;L BUILDING TYPE: kSFR-DETACHED D SFR-ATTACHED D DUPLEX O MULTI-FAMILY-#OF UNITS: D COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 5551 ., `'°'. NUMBER OF DEVICES(If low voltage): (t) r ir - k ( 1) A e 4,8, FIRE ALARM? D YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): //�� DESCRIPTION OF WORK: eIti,q (, b4tX (00k. f - GGAA&JD;.4b/) A%/'L.L./�i+✓jJ/T7mitt, • • Ray* �-- CONTACTIRE ALARM? 0 •NAME: RayIQ 1t) A J (e,Z, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ff r k 0(1, - ZVI' /ham 5'L� cny c v e/2- STATE ii..4). _ ZIP MOD() OWNER PHONE:( # ) 7 f 1 — 23'7 3... OWNER EMAIL: U k t-1z y fere_,&kl,S jI, (V/41CONTRACTOR NAME: EVC l.- o.y .i4-f-e- 1-1�'�r `y. ,,6I CONTRACTOR ADDRESS: STREET ZI�® tl-�(:t--E��t CG - dITY L-A/q7ecI / l STATE ( ZIP ga. CONTRACTOR PHONE(tJZ') i1-3//C CONTRACTOR EMAIL: /(lei'i :.�/rr� cm Lve boat CONTRACTOR LIC.,#(REQUIRED): ,5 6/.2.j ) CITY OF EVERETT BUSINESS LIG.#(REQUIRED):00- s-- - PRIMARY CONTACT:- El OWNER lY CONTRACTOR D OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: r..Fig,- z5-2_-3'//Lfr T�.-:-.k) ,CA CONTACT EMAIL: i.e.L w co yl,.j Luc G.. CIytZ AGREEMENT:I hereby certify that 1 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 l 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. I _ City of Everett Official Use Only PERMIT# /L___ ._.c.::S Y- 12--- 11 E l q OF)-(71 D Owner/Authorized Agent Signature Date (Revised 9/23/2016) 1