220 77TH PL SW 2019-09-18 - Laserfiche WebLink

ILECTRCAL PERMIT AFILIC' TIO .44/;":"74 Niiii w 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 J www.everettwa.gov/permits PROJECT SITE INFORMATION' PROJECT ADDRESS: a D,C) -1-1 `44h ?L- ' uj BUILDING AREA(if residential,new construction,remodel,or addition) SF • BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: +Q ).,411N1 aaawaseaq ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ /,D5 O NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: tO p 1 AG?. r9.00 p Loe.,ci cf:),A-2,9_ • CONTACT INFORMATION OWNER NAME: J DoVt., c..._62. 1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 2-2-0 `-n-t'` c2L . u.,,, (Q� CITY ekx.r-e. STATE tjj.l. ZIP 1co(an OWNER PHONE: s C OWNER�EM�,AIL: CONTRACTOR NAME: <C`O,S5\a 1 E`ac. c'�CO',l.. . W,..,'. CONTRACTOR ADDRESS: STREET P• 0, x 01 Lt 0 CITY O it STATE VSA, ZIP ai g a p CONTRACTOR PHONE: 'OS-339^339 j CONTRACTOR EMAIL:Ciao , Vcc3SS11t3© C.or, i, ,nP r CONTRACTOR LIC.#(REQUIRED): KCgSS gG scin Q6' CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O 5© 16 PRIMARY CONTACT: 0 OWNER XCONTRACTORry 0 OTHER(Please Specify) x.,y..w..-,,..~.,��`~~��_'....µ....,..,_.....�x.......,.._.____._�. CONTACT NAM5: CONTACT PHONE: (_f5-- 1 5 4t+ -Q D o c-oss -) CONTACT EMAIL: `7 'AGREEMENT.:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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!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 FEE 004 111V l' PERMIT# 0 ' 'Ca -' — E '19)0 ,-()(19G Owner/Authorized Agent Signature Date (Revised 10/12/2015)