6202 ROCKEFELLER AVE 2022-10-07 - Laserfiche WebLink

0 "it !LECTRICAL PERMIT APPLICATION 4 OD S 3200 CEDARCITYFE STREETERETT, EVERETTPERMIT , WAERVICES 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION`: PROJECT ADDRESS: V�0._ K , .,_, ,, BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: IYI SFR-DETACHED 0 SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: O COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ ( 1 NUMBER OF DEVICES(if low voltage):. FIRE ALARM? GLYES ifSKO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 200 A- c Pi°ro8Z [ 1M.ET , A O- 6 c&4 CONTACT INFORMATION. ti- OWNER NAME: `ems ,6 o,...)-- TENANT NA E\ If Commercial): MAILING ADDRESS: STREET (.9 Ze5[;k:t C L `? cny )O f e `�, STATE CO PC- zwR ', �__C 2 OWNER PHONE: "3,rj�1 - . OWNER EMAIL: CONTRACTOR NAME: _7QeJd— CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQU D): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) / CONTACT NAME: CONTACT PHONE: 'f 2 3sj? -./' , 0 „te l 6 i2[9zc9 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 t am authorized by the owner of this properly 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 4 Do _ PERMIT# C))0n-kyrk___ .4.4_... ‘,..,"t- s Owner/Authorized Agent Signature Date (Revised 10/1212015)