2801 BAKER AVE 2020-12-18 - Laserfiche WebLink

ILECTRICAL PERMIT A•LICATION �R/ CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 j FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATIOPI '' PROJECT ADDRESS: a9_ jO( Qt Ke Z ,wa e u-&(-'C7 ( lea or) BUILDING AREA(if residential,new constructio a od>,or addition) e 0 SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: tLe vsc eket,,a ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 5°too• NUMBER OF DEVICES(if low voltage):• FIRE ALARM? ❑YES ENO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: \ (tit J_ 9 f re &oX cj • CONTACT INFORMATION OWNER NAME: M 11g-r( N \ 0 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET SI 2'3 ty=w&LL_ (2A rG cny 's uaeeC - STATE VT± ZP 7 "or OWNER PHONE: ((IS— 3C(4_ Th710 OWNER EMAIL: M Cc\AI t k v C0 Li V E ` C o A4 CONTRACTOR NAME: Q IM W E CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): _ ..._ PRIMARY CONTACT: OWNER IDCONTRACTOR El OTHER(Please Specify) _ T'_.........,.,.-. .......�............._.,.....� 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 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 am authorized by the owner of this propertyto perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE usuelp PERMIT# - Il e0(3o(2°ice E 11 IL\ Lo r7.gr ipi d Age't Signature'� Date (Revised 10/12/2015)