8612 XAVIER WAY 2016-05-27 - Laserfiche WebLink

OLT 1ECTRICAL PERMIT AF ..ICATION CITY OF EVERETT PERMIT SERVICES C- 16 6 3 —0 s73 3200 CEDAR STREET, EVERETT, WA 98201 3,.ttt. t& (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits • PROJECT SITEINFORMATION PROJECT ADDRESS: e3 I c)l` a !i.\ 1" e Q\ W i BUILDING AREA(if residential, new construction,remodel, or addition) V SF BUILDING TYPE: ❑SFR-DETACHED MSFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: HOi'Yl ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: euvnI chokivij Le CONTACT INFORMATION OWNER NAME: co/Vv/y � ig TENANT NAME(If Commercial): OWNER MAILING ADDRESS: / STREET SV ( a V I'?r ,1' /ji1 / CITY E:Vt L STATE 14/ / ZIP OWNER PHONE: Li 3 oto- OWNER EMAIL: 61 one)f ;+Ei✓700/)ipwCy _tth CO✓j7 CONTRACTOR NAME: /41.-1- A.) e.\A1 A 4(tkl CONTRACTOR ADDRESS: STREET /S YO *70 3 i1 ' ' S` CITY MIL// Gy �i ) STATE A/4 ZIP 4/ D/� CONTRACTOR PHONE: 6--/1,j 5 36 7j. CONTRACTOR EMAIL: 0/I/A 4e h./0,1mi,-, A CO 0'? f Y CITY OF EVERETT BUSINESS LIC.# ,T Ts CONTRACTOR LIC.#(REQUIRED): //��Nrr Q /� (REQUIRED): CONT .... _...._ .....,,._..__.._., ._.,.!�L.... ,._,.... ll�......._ _U ...._... . _._. _._............._ ......... ....._._... __._..,_ _......--•......._..... ........ _,..: PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: go b ..(j5`S——3 6'71 f► of ri o/ 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 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 FEE 11 1 0®_6i PERMIT# 3 dOi& E1L06 - O Owner/Authorized Age •. . • e Date (Revised 10/12/2015)