1415 52ND ST SE EVERETT STAR ADULT FAMILY HOME 2020-06-18

ELECTRICAL PERMIT APPLICATION I�►� y- 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 l www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 415 52nd Amentte SE _ BUILDING AREA(if residential,new construction,remodel,or addition)1,816 SF BUILDING TYPE: la SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Single Family Residence ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1,500.00 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): 40-6( --1 I - C DESCRIPTION OF WORK: See Attached CONTACT INFORMATION OWNER NAME:Halima Khamala TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1415 52ND ST SE cm, Everett STATE WA ZIP 98203 OWNER PHONE: 206-427-7411 OWNER EMAIL: CONTRACTOR NAME: Owner/ Resident CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206-992-4982 Fred Brown CONTACT EMAIL:fred@ffbrowndesign.COm 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# 41 EL� i - o7 / Owner/Authorized Agent - gnature Da (Revised 9/23/2016)