12906 19TH AVE SE 2020-05-18 - Laserfiche WebLink

OLT !LECTRICAL PERMIT APPLICATION 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 90/ _ /J _PROJECT SITE INFORMATION� PROJECT ADDRESS: /0lD 5,—M.-hli ere</ // BUILDING AREA(if residential, new construction, remodel,or addition) S-1 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED- 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: OCOMMERCIAL USE OF BUILDING: -'v'( v 2-V LECTRICAL PPLICATION INFORMATION CONTRACT PRICE OF WOR : . Oa° NUMBER OF DEVICES (if to voltage): ll FIRE ALARM? 0 YE'. 1360 ASSOCIATED BUILDING • RMIT#(if app'•.ble): DESCRIPTION OF WORK: C1/L'k area. i L)//ec/ fr/17- R. ,9/ sirs avid 3 casvc..eres, CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: gpg/i(r® -e�Gcn I�� S'y S le-04S CONTRACTOR ADDRESS:/ STREET 6 (a8' 1m/u$(7"j DrZ, CITY t0144)t 1,4- STATE V(/ ZIP ref 8:48-- CONTRACTOR PHONE:3( -- �' /(,c9--J CONTRACTOR EMAIL: /m h( ,f1"Qd 19a/ � , LyyL . CONTRACTOR LIC.#(REQUIRED): � ' ! t lT�/� //-S X/ �(,,p{ /p >�[� CITY OF EVERETT BUSINESS LIC.#(REO,.IRED): ... ...,. ., PRIMARY CONTACT: 0 OWNER �CCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -3600 3 9 / /k/1 l a I S1-^601 CONTACT EMAIL: /h"y1 , flop s1-4.64°1 0175 'Le- 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 0,"er/Authorized Agent Signature Date (Revised 9/23/2016)