3716 ROCKEFELLER AVE 2019-11-07 - Laserfiche WebLink

��!!!L ECTRIC L PERMIT AICATION 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 I www.everettwa.gov/permits // �'Sli'1�•�1�►1FgRiV1,A`>:IAiV C�' PROJECT ADDRESS: !/6 , . .f / g. . ': . n ,�e .. d f .e / ��r BUILDING AREA(if residential,new construction,remodel,or addition).��0 ✓ SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 4131154_ ELEG i'RICAL APPLICATION N� FORMATION . '.. :.. .._... .. .. ..:. .:......•..:gip. ._..,,w.,,a:...::. •..a :. _i. .. .. .- ... ... .. _ .. ..__.._ _ _._._ CONTRACT PRICE OF WORK:$ 0 00, (3f NUMBER OF DEVICES(if low voltage): FIRE ALARM? [DIES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -€-Iml -1 '77 ->N 7l619r• ..:..... ..... CO[�. FOR TI N:..--:. - OWNER NAME: O-W►�j , �.(� t 1 h S-a.--YVNANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReer Z31/ 1 6rei1 CITY STATE 4 ZIP (7O OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CnY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC,#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:T hereby certify that I 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 lam authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCI and 296.200 WAG. City of Everett Official Use Only FEE 00 PERMIT# Owner/Authorized Agent Sig nature Date (Revised 10/12/2015)