7 77TH PL SW 2020-06-19 - Laserfiche WebLink

odow _ECTICL PERMIT AI _ICATION ------ 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 j www.everettwa.gov/permits • PROJECT SITE INFORMATION' PROJECT ADDRESS: 1 1-1 1 P 1 S 1,4) BUILDING AREA(if residential,new construction,remodel,or addition) "! SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTII-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ �7 Di) . o'er NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO "- ASSOCIATED BUILDING PERMIT#(if applicab e): �j 1-1 0-7-0 5-3 �+, DESCRIPTION OF WORK: (el6htt CAA fav am. laptivoewl CONTACT INFORMATION OWNER NAME: 16€-V C) 'f q A Art.(Al TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 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: CONTACT EMAIL: AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. Al/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 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 411 5-1 O'er PERMIT# ,r) E n b I- 0'10 Owner/Auth ed •lent Signature Date (Revised 90/9212095)