9900 12TH AVE W 2016-06-01 - Laserfiche WebLink

je._„.01.0:::a ELECTRICAL PERMIT LICAT ON , CITY OF EVERETT PERMIT VICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 ] (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT'SITE INFORMATION PROJECT ADDRESS: /TOO 0-."h 1g ye W Gvei2-614- 78 20'1 BUILDING AREA(if residential, new construction,remodel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: Ij COMMERCIAL USE OF BUILDING: L.�p�n 5 b a;e 10/.1 ko ,pfy ,S ELECTRICAL APPLICATIONINFORMATION '' CONTRACT PRICE OF WORK:$ 7",`,-ic $ y'1i4 tc4 1 4 15p,OD- . o, NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES TNO ASSOCIATED BUILDING PERMIT#(if applicable): r DESCRIPTION OF WORK: 44-�r G,Az) B C14" Al t. 11%.4- P`d Un 43 • CONTACT INFORMATION OWNER NAME: r TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY _ STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: . ✓h CONTRACTOR ADDRESS: STREET P 2 g Pap/4 2. FM cc ysdik CITY Sc o4- STATE L"//T ZIP 99/941 CONTRACTOR PHONE: a.4 co 3oT 7-,,,74 No CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): 6M mit4-tObig it' CITY OF EVERETT BUSINESS LIC.#(REQUIRED):OU,;1 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR DA OTHER(Please Specify) C/e.CA'R,G1/1-s✓ 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 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 (eUG l . PERMIT# • 3- 3/-116 E1 .gb3- 202 0 /Autliori gent Signature Date (Revised 10/12/2015)