8215 BROADWAY 2020-04-01 - Laserfiche WebLink

ELECTRICAL PER IT APPLIICATI N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 f FAX 425-257-8857 1(E)evorotteps@everottwa.gov www,everettwa.gov/permits PROJECT SITE !INFORMATION PROJECT ADDRESS: <3 21-77- 74.1 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: XCOMMERCIAL USE OF BUILDING: ELECTROCAL APPLIICATI1AM INIFI)RiVIATION CONTRACT PRICE OF WORK:$ •5109, NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 1)15601- e P0(4)67A_ yfildiuo Sy.5'tjw. . . ., • . , • • • CONTACT INFORMATION ..„ • ... • . . • • OWNER NAME: , 671Z.ViCZ5- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rageT Fat 5Brze-Ab CITY L.0 STATE lak , ZIP 4n 2173 OWNER PHONE: ( f:9 0- 6 OWNER EMAIL: CONTRACTOR NAME: ef).- 1 CONTRACTOR ADDRESS: STREET 2-i 20 tr41647-c--e, CRY antd STATE (AM" ZIP 9Te CONTRACTOR PHONE(./451 '61-3)19 CONTRACTOR EMAIL: ke/L) CONTRACTOR LIG.ii(REQUIRED): ag , 50:( 7" 2M CITY OF EVERETT BUSINESS LIC.#(REQUIRED):04 C' ".•• . • " • • • ••. . _ . PRIMARY CONTACT: DOWNER KCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: k.fn,_ ?fi ( 0 co NTACT EMAIL: AGREEMENT:I hereby earthy that I have read and examined this application end know the same to be true and correct All provisions of end 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 previsions of any other state or local law regale:Mg constructkm or the performance of construction. That/em authorized by the owner of this property to perform the work for which application Is made end! comply with the State Contractors Law 18,27 ROW and 20.200 WAG. City of Everett Official Use Only _ PERMIT Owner/Authorized Agent Signature Date (Revised 9/2S/2016)