3731 COLBY AVE FULTON LAW OFFICE 2020-02-06

"IPP.0.4/‘C--A ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 l FAX 425-257-8857 ((E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 7)( Gd l (, BUILDING AREA(If residential,new construction,remodel/or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ©r-Pal; • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 2-61).rJ� NUMBER OF DEVICES(if low voltage): - • FIRE ALARM? 0 YESNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: S PLCT J pr.jdoe:c7 ppweti Cr t/Zi • CONTACT INFORMATION • • • : • OWNER NAME: 61A (Z n tz- ( I---t—c J t7 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 371 3 ) ( t / CITY &.ve77 / ( STATE LOA 4. ZIP el OWNER PHONE: r, ,, OWNER EMAIL: A/n/ CONTRACTOR NAME: EVt4 = 1.J Acre Q4T 1'-} 1 A/I CONTRACTOR ADDRESS: STREET SI 2 0 tj •-E•t c- • CITY a/e(Z.ezi STATE WA- ZIP 9.6- ( CONTRACTOR PHONE0a0 2s 2---?/(4 CONTRACTOR EMAIL: CONTRACTOR LIC,#(REQUIRED): ,i5�� CITY OF EVERETT BUSINESS LIC.#(REQUIRED),OO7q j-j- PRIMARY CONTACT: 0 OWNER ErCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t.fig 252..— C� 14.1-1\J �'L 4) CONTACT EMAIL: J�'G rti ClJ cf7 55-lV7 �u eCrIm AGREEMENT:I 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 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 PER IT (52;./4 E iqeD6—CIC6 Owner/Authorized Agent Signature Date (Revised 9/23/2096)