4011 FEDERAL AVE 2020-02-07 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 1111:' —A- 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 z , ,. x PROJECT IT INFORMATIONx . ., v. . w h> PROJECT ADDRESS: yQ// 1*"—Te ie r e ( /1 v e. . E✓e., H BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ®SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 2 a.;,,,k c,A,•,,_ I '',, ELECTRIC L Al PLIC'A' ION INFORMATION x CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: it fda\-t. kna\N f 'i,14_ CA tr ting la e.urr e.vA c4-0L iw Af/YOGI M(-- 66 el- el- v ,re-w.AILA CONTACT IN:#0404#TIOM�IO ' 1 OWNER NAME: J O Nva a r.k-ir\ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET etO (( RA e y--0,_1 A-0 e_.- CITY _CITY lF V e—r,. STATE U) i ZIP 9gazo ( OWNER PHONE: '{2 S` 334 OZc.3 OWNER EMAIL: t b k .v - .�0 i3 c.(oe 4 i Le rv. CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET crrY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 'J OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: --,u�, `n/�,� v v \ar 4-it. CONTACT EMAIL: 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 I am authorized by the owner of this property to perform the work for which application is made and t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only / PERMIT# Z\......, r 7/2-k. E nil- t(0(p 0 n /Authorized Agent Signature Date (Revised 9/23/2016)