2202 112TH PL SE 2020-06-15 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION Cum FT 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 ;. . •� �: �: .�-: : `':: pE•:GJLCTSIITIEIIGdFO • .. .... . PROJECT ADDRESS: (/ DQ. PL.S L S BUILDING AREA(if residential,new construction,remodel,or addition) 2.2' SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX Cl MULTI-FAMILY-#OF UNITS: 1 0 COMMERCIAL USE OF BUILDING: gLIECT`.BCc-AL APPLUICA`1T0®IM IMF*f`!MA`II'Q>M ': .-- . CONTRACT PRICE OF WORK:$ 76 c.)0, 6 0 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES LSI NO ASSOCIATED BUILDING PERMIT#(if applicable): ++ DESCRIPTION OF WORK: Lief,,, Cc) vv.C-4--l'0 v\ („' i Y' I I^or (Ai T I ` 11 I-1 OWNER NAME: ,. \ ( ikA, 0 e Juts tfr1 oily „„AA TENANT NAME(If Commercial): u cy OWNER MAILING ADDRESS: sTReEr coy STATE ZIP :OWNER PHONE: / OWNER EMAIL: CONTRACTOR NAME: y,'t � 6 jV [� e 1 C {V i C S e%U( C CONTRACTOR ADDRESS: sTReEr q j g 1 3 4 4i- A ue 5 E= CITY V 0 ti.) C G.S 1 -e-/ STATE ZIP CONTRACTOR PHONE: DCO C --77 5 ;:CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): AJ 9 5 S CITY OF EVERETT BUSINESS LIC.#(REQUIRED): I Ll PRIMARY CONTACT: 0 OWNER V'CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 1 CONTACT PHONE: 9 O�-_ 775_ Y-9-q7 S� f f f k 0 o S ,LA 1 ✓�.C� L' 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 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 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 an.d 296.200 WAC. City of Everett Official Use Only i FEE 0a PERMIT# a I 7Sr E ` oS ner/Authorized Agent Signature Date (Revised 90/92/2095)