3525 COLBY AVE BREWE LAYMAN 2020-02-06

ELECTRICAL PERMIT APPLICATION 411g1 CITY OF EVERETT PERMIT SERVICES 1I�� 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 } FAX 425-257-8857 I (E)everetteps@everettwa.gov J www.everettwa.gov/permits f PROJECT SITE INFORMATION PROJECT ADDRESS: X52 S dd. BUILDING AREA(if residential,new construction,re odel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: et.cct • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(If applicable): DESCRIPTION OF WORK: cc d 04,,.1I<- C l G y�+a,�,.�°�- (314.6(042, (.:T)I4.—. A.,614./ Ldp (.4-(/)v"+-e Zr • CONTACT INFORMATION • • OWNER NAME: &L'L L/4 ,1, .t...) TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 5 AZA Le) it c" tv� STATE t,(.2A-t ZIP OWNER PHONE:ittA" — /607 OWNER EMAIL: CONTRACTOR NAME: l..V csp (.44-re l-1)')A c- A i CONTRACTOR ADDRESS: STREET 'Z.I 20 % t.-47G , CITY az-ear Z i STATE CI , , ZIP 9-8 CONTRACTOR PHONE(4/7-61 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): 'j',5j'1.j ) CITY OF EVERETT BUSINESS LIC.#(REQUIRED),06'7�rjc PRIMARY CONTACT:- D OWNER SCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1/4.(24-3',- 25'2- / ''Lt..) CONTACT EMAIL: k- oy cP'5S,v7 iu *CIYJ)nz AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. Al!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 property to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT# 6::;:‘ Owner/Authorized Agent Signature Date (Revised 9/23/2016)