10626 WASHINGTON WAY 2020-04-03 - Laserfiche WebLink

!LECTRICAL PERMIT ANILICATION ve 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 PROJECT SITE INFORMATION PROJECT ADDRESS /062.‘ (A)# 55J2/C�77 // vie/ 6-7„6/24// 1.014 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:$ 2 � NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES -"SrNO ASSOCIATED BUILDING PERMIT#(if applicable): A DESCRIPTION OF WORK: S L.Ia CQ, C i-f14/,e OUT /Lt)S /U9/py? SC/,6 /a/9/X% /0 .(_i614) /4. Di�, 7i4 CONTACT INFORMATION . OWNER NAME: /...7j/177-A/ /.7i,;L+e yTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /4062.,,<- ln/iticlijjeJ/,/ W[19-/ CITY 6:1/6/2///&/// STATE 40/ ZIP OWNER PHONE: OWNER EMAIL: ... . CONTRACTOR NAME: 13/9-02P/L 'eC:42,/� i . ... .. CONTRACTOR ADDRESS: STREET/99D2 / . S% S-LI.) CITY (A)/61.67- Q STATE 44/i/4 ZIP 5 ;;. ,S/ CONTRACTOR PHONE:6/25-::..r72-V.5-9/ CONTRACTOR EMAIL: ' CONTRACTOR LIC.#(REQUIRED)•40 ()Zeta5-�s-4/,e7 CITY OF EVERETT BUSINESS LIC #(REQUIRED . _ X33 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 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 oflaws 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! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE ( OO .........--- )3()., /, PERMIT# Agent Si na re Date (Revised OwnedAth rizedg � 10/12/2015)