2915 17TH ST 2020-06-03 - Laserfiche WebLink

LLECTRICAL PERMIT APPLICATION NINig' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I vwvw.everettwa.gov/permits • PROJECT SITE INFORMATION PROJECT ADDRESS: 7..fir- /76 SI- Ft/6 (�t/'f f- W l BUILDING AREA(if residential,`new construction remodel, addition) 774- SF BUILDING TYPE: OIL FR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ave, - Cj : /6 E .ECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ — • NUMBER OF DEVICES(if low voltage):• f i-A , FIRE ALARM? ❑YES PAO • ASSOCIATED BUILDING PERMIT applicable): DESCRIPTION OF WORK: 5.1 7, ),(057, (ii / OQ 7 ) p 9e49 jf-- /Q6DocAr67" glc-7 r /1`5 P)p1/ cv z 7 f 72 ii-p I z iAlAc a'"I le &-z& _ 57,94-(-6 /-1614 ,11. ‘/osil0/ . - CONTACT INFORMATION • OWNER NAME: / 4Qft5Z, .c.5,-/M/'0 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET/ f/) y5/[/y�(��{- L'- 1i) ' �,�,/�� CITY L�_ �� '"_. STATE 2' ' _ /� ZIP � . OWNER PHONE:4'r"36f 1 12 OWNER EMAIL: � -efil e 1. ,1 CONTRACTOR NAME: OW/V612, 3' T` fL� r /Waif ' CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR PA•THER(Please Specify J' = // �/ CONTACT NAME: CONTACT CONTACT PHONE: A r i f 5 A ia, Iry << 0. CONTACT EMAIL: t� �$ a'a 4 ! !L'r �1AGR FMENT:yt-f-ripA ereby certify that I have read and examined this application and know the same to.e true a d correct All provisions laws and ordinances governing this type of work wi completed whether specified herein or not The granting of a permit does not presume to give authority to violate or ancel the provisions of any other state or local law regulating construction or the performance of construction. That lam 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 FEE r.y 41100. O PERMIT# ,. E I 0-1-'125 Owner Authorized A• nt Signet i re Date (Revised 10/12/2015)