2126 112TH PL SE 2020-06-15 - Laserfiche WebLink

. -ECTRICCAL PERMIT AP.O,� JCCATION CITY OF EVERETT PERMIT SERVICES gOrif 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 Pr (0. `i(.slam IImI © ,TOO PROJECT ADDRES DC I\ BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED)(SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTr'IICAL APPLIcAT0®Ir i 6NFOTIIMM CONTRACT PRICE OF WORK:$ 7Ot NUMBER OF DEVICES Of low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT (if applicable): DESCRIPTION OF WORK: L�e — ^/e G,J fo w J OWNER NAME: <} ' L?f I rA-ke TEN NT NAME(If Commercial): OWNER MAILING ADDRESS: STREET et evOufd orrr I a r STATE (` ZIP l !, OWNER PHONE: - Q c9-Cs6O OWNER EMAIL: CONTRACTOR NAME: 'AMA -i h } e VPC ✓ tc of Se r v t c.e S C C CONTRACTOR ADDRESS: STREET 5 7 1 8 137-1-A A Ue S (- CITY Ai to C.c f[e STATE .A ZAP otSios 9` CONTRACTOR PHONE: CONTRACTOR EMAIL: 1-414 C41 CONTRACTOR LIC,#(REQUIRED): -T-(uF :KIEa CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 2'OTHER(Please Specify) 0.y\� Ge(Am t-- cpAA) CONTACT NAME: CONTACT PHONE: CP/ ( �)- 7�-y-- � �7 3 b cq CONTACT EMAIL: tAx0 + AGREEMENT:T bey o ithat l Ghave read i 14 wciok t i ( 1 f C a and examined this application and know the same to be true and efrect All provisions of laws !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!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 FEE •// ' PERMIT# 9( t7Y F (6(P ONo I Owner/Aut.• !ze' d Agent Signature Date (Revised 10/12/2015)