5116 HARBOR LN 2020-01-29 - Laserfiche WebLink

ELECTRICAL PERMIT AP,c UUCAT1•N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov C www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT-ADDRESS: 5 11 vete IUt: BUILDING AREA Of residential,new construction,remodel,or addition) SF BUILDING TYPE: ©SFR-DETACHED D SFR-ATTACHED D DUPLEX 0 MULTI-FAMILY-#OF UNITS: D COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ O , NUMBER OF DEVICES(If low voltage): 2. - "j- hi- FIRE ALARM? D YES EI NO ASSOCIATED BUILDING PERMIT#(If applicable): �} DESCRIPTION OF WORK: 1).4.k)�. l=r-. `- -t z..5 t',�-s zit A•C 1 i t ,4 f) 'c L. t /044 ! ritolo U 4ii2_. 21t l t , i • f)t-5 f3M1 c f g CONTACT INFORMATION _ ' • OWNER NAME: 'may > t Al[ i y TENAN/T NAME(If Commercial): OWNER MAILING ADDRESS: STREET 51 1 (0 H..Ri �} n CRY Evezzec STATE y(yj , tip ! ,20 OWNER PHONE 44.51 •7 -of ..7 ,OWNER EMAIL: CONTRACTOR NAME: L;v/ ., C I,4ef'Z` CONTRACTOR ADDRESS: STREET r'ZI 2.0 til( 1.-E t G a Carr l i STATE WAz:p95'Zcf CONTRACTOR PHONE(f j ") 2c/-31 09 CONTRACTOR EMAIL: kLe-c)<-'4,5C.514.4 a fif t.Z CONTRACTOR LIC,#(REQUIRED): t ,V€f Z I CITY OF EVERETT BUSINESS LIC.#(REQUIREDWC1:71S5'- PRIMARY CONTACT: D OWNER ( CONTRACTOR D OTHER(Please Specify) _ CONTACT NAME: CONTACT PHONE: lfZ 2 2 - k) 1.-C.) CONTACT EMAIL: ice cp. cfl.s.57 Ltf earyt. _..__ AGREEMENT:!hereby certify that I have read and examined this app//cat/on and know the same to be true and correct All previsions of/ewe and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to glue authority to violate or cancel the provisions of any other state or local taw regulating construction or the performance of construction. Tat!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 1&27 ROW and 2911200 WAG. City of Everett Official Use Only PERMIT# /0 " E tqt0-05 Owner/Authorized ent Signature f"" Date 6(Revised 5/23/2016)