5221 23RD AVE W 2021-09-02 - Laserfiche WebLink

!LECTRJCAL PERMIT APPLICATION I�►��-r1. CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERE l I, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa,gov j www.everettwa.govlpermits •�Sl' `�O -� T P._ ■ PROJECT ADDRESS: ?-2—1 - j k- LA! BUILDING AREA(if residential, new construction, remodel,or addition)_ ,SF BUILDING TYPE X SFR-DETACHED LI SFR-ATTACHED E DUPLOC Cl MULTI-FAMILY-#OF UNITS: » COMMERCIAL 115E OF BUILDING: �� �:�Pi'�11G MFO P.� �� .ae. ...,. ,J .�,., i', %r w;�'i.r.'rw5�s . •..,� - n,ef.i...cv.:`:..., .,,.... . �i�:.yrck .r, a._.- •5.,..� Y.ti:{r,:•�r CONTRACT PRICE OF WORK:$ !111 ZZ3 --- NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ) NO _ ASSOCIATED BUILDING PERMIT 4(if applicable): DESCRIPTION OF WORK: � PLOc. cc)T�-�' 3> L-L4 T� A S W kT 1 -/ ° j k t-)S'} -4- F-e_e_7 1 -. L).) L-t - ND 6 2-) 7Z— S �� I�iLs � t. Z(�2" � OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sir. r, 5-7—'1-11 "Z�j rL�-i/.E Lam) • 1� '^_. CRY �-�V-�V��- �1 STATE: y- A OWNER PHONE: 1 OWNER EMAIL: • 4-u--i G �� CONTRACTOR NAME: - -peeCONTRACTOR ADDRESS: siEer .1;72 tom' It ( Q3 1 — CONTRACTOR PHONE: J �~ `$1 I CONTRACTOR EMAIL 1 7c2l° n CONTRACTOR LIC.TE9UIREaXtelP ? g CITY OF EVERETT BUSINESS We.#(REQUIRED)' 2. PRIMARY CONTACT: © OWNER CONTRACTOR ❑OTHER(Please Specify) . CONTACT NAME: - CONTACT PHONE: �`L� (P 51 l CONTACT EMAIL: - ,-)c". �_D{� 1+3�►2LG.v ✓� AGRLEME m T hereby certify that I have read and examined this application and know the same to be true and cvtract All provisions.of laws and ordinances govemrhg this type of work ma ba completed whether specified herein or not The granting of a permit does not presume to givo authority to violate or cancel the provisions of any other slate or looei law regulating construction orthe performance of constfuction. That 1 am en}horired by the caner of this property to perform the work for which application is made and l comp'with the State Contractors l eW 15.2T ROW end 2Pti200 WAG City of Everett Official Use Only FEE ' o t,S v q. PERMIT if dej't/ E Ot Owner/Au - sd Agent S nature ( pate (Revised 10/12/2015)