1607 73RD ST SE 2023-07-31 - Laserfiche WebLink

ii_ECTRICAL PERMIT ANLICATION 4.77. CITY OF EVERETT PERMIT SE VICES 3200 CEDAR STREET, EVERETT, WA 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: Lb07 73'1rd ( zQ 3 BUILDING AREA(if residential, new construction, remodel, or addition) > (000 SF BUILDING TYPE: gSFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ SOCK NUMBER OF DEVICES (if low voltage): o FIRE ALARM? ❑YES 'NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ACAk OtA r-(se4'7 1.,(cj , c 'l V CONTACT INFORMATION OWNER NAME: 'C M\. kAe .S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET tbO7 YiA CITY LI STATE VV ZIP CW05 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Ow U\2r- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: j5C6WNER ❑ CONTRACTOR ❑OTHER(Please Specify)� CONTACT NAME:�� 1n��( CONTACT EMAILCONTACT : �vif � �G�� co� Y` 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 I 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 WAG. City of Everett Official Use Only FEE 4tooto, ), PERMIT# —6 c� Eft fl o\ D Owner/Authorized Agent Signature Date (Revised 10/12/2015)