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5405 EAST DR 2020-05-18
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5405 EAST DR 2020-05-18
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Last modified
5/18/2020 9:09:58 AM
Creation date
5/18/2020 9:09:36 AM
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Address Document
Street Name
EAST DR
Street Number
5405
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g-Tr _ECTRICAL PERMIT APICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov j www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 5y©5 x-57- J . EUI (A/4- 678-0..c2 3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) 4/g1) SF <br /> BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 D LEX 0 MULTI- MILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: !14, OT--(f-(.e_ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 2000 <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): ?W 1?©ly oO g <br /> DESCRIPTION OF WORK: ✓I IZ E' ¶7,V'1 NO cJ 'E <br /> CONTACT,INFORMATION <br /> OWNER NAME: oS \ 5M1i(+ SITE Er TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ,j c/o>j EA-s1 pia '. �//�' <br /> CITY 6-(4:51Z-�7y C .,p p L, �STTAATE W� ZIP 'e- 3 <br /> OWNER PHONE: 246 -83-0-5 6't 2- OWNER EMAIL: 5#l l/I Wt J e. 9-7 gJQi( C d)44 <br /> CONTRACTOR NAME: <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): <br /> PRIMARY CONTACT: krOWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACTNAME. CONTACT PHONE: 20 — S j' -- 3 6 /2 <br /> 36Sl _ CONTACT EMAIL: G�►�€�-wi se 7-1 „gptpie7, CIW? <br /> 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 <br /> 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 <br /> 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 I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> - PERMIT# <br /> E g0q- —02_ 1 <br /> Owner/A honzed Agent Signature Date (Revised 9/23/2016) <br />
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