6926 COLBY AVE 2020-02-06 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION - -.- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 ( (E) everetteps@everettwagov I www.everettwa.gov/permits PROJECT SITE INFORMATION::_ PROJECT ADDRESS: CO 9 ac, CO \ bct At,e 0 C..?'ec2'G 8-2-03 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: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ I NUMBER OF DEVICES(if low voltage): FIRE ALARM? CI YES 0 NO ASSOCIATED BUILDING PERMIT#Of applicable): DESCRIPTION OF WORK: �--e \C C.o_ L ti c-l CONTACT INFORMATION .: OWNER NAME: ( ii yl-N_ CS cm 3 TENANT NAME of Commercial): OWNER MAILING ADDRESS: sTREEr C, b ct acsc. S ct1 CITY EC.... /,Zg STATE (l ZIP qR OWNER PHONE: (t7,. 3(.0 7 • St Lt.$ OWNER EMAIL: CONTRACTOR NAME: k c v p CONTRACTOR ADDRESS: STREET apt n�c lam _. 6 r...) (c-e_. C)f' crrY y1�4�t W TSL- STATE ry ZIP C7 U _5.O CONTRACTOR PHONE:-�O. - ? CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): (<:AyLl•t , C 1CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ca37..3c 4 PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) • CONTACT NAME: CONTACT PHONE: L-` 3 C.,t,"")< (LE,s \ 3 b� 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 th;s 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 1 am authorized by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE q—B PERMIT# 411 Owner/Authorized Agent Signature Date (Revised 10/12/2015)