1901 MERRILL CREEK PKY HEARTHSTONE APTS 2020-12-29

M-ECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 ( (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6 C F • C t R4 jgaj BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED CI SFR-ATTACHED ❑DUPLEX ,&MULTI-FAMILY-#OF UNITS:, _ ©COMMERCIAL USC OF BUILDING: te � ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1 J7 --- NUMBER OF DEVICES if low voltage): FIRE ALARM? ©YES NO ASSOCIATED BUILDING PERMIT# if applicable): PoAA— DESCRIPTION OF WORK: Q�cs ' �d d�kp �s X4u.RA— L 90 a� dais, CONTACT INFORMATION OWNER NAME: C. TENANT NAME(if Commercial): ;J , OWNER MAILING ADDRESS: STREET CITY C STATE l' \,j ZIP , ! OWNER PHONE: OWNER EMAIL: e_ ty S (6 K . Cc5 CONTRACTOR NAME: CONTRACTOR,ADDRESS: STREET CITY re_r� Q STATE ZIP CONTRACTOR PRONE: 2C-141 3 CONTRACTOR EMAIL: 3 6 q3 _ CCY CONTRACTOR LIC.#(REQUIRED): a .'�rIr L 6-6!IJ G CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ©CONTRACTOR )&OTHER(Please Specify} s itA,C' CONTA T NAME: CONTACT PHONE: zT —5 .3G 6 4 7'(:: CONTACT EMAIL: A� J t a G C1 AGREEMENT,T hsreby certify that l 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 focal law regulating construction or the performance of construction. That t am authorized by the owner of this property to perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Oficial Use Only FEE I ' 1f I PERMIT# Co0 b Owner/ Chorized Agent Signature Date (Revised 1011212015)