9629 16TH DR W 2016-06-01 - Laserfiche WebLink

41err ECTR CAL PERdVHT Ar_r—LIC iflO CITY OF EVERETT PERMIT SERVICES 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: ;140"-Z BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ -ltso NUMBER OF DEVICES (if low voltage): fZS FIRE ALARM? ❑YES It NO ASSOCIATED BUILDING PERMIT#(if applicable): q5 DESCRIPTION OF WORK: 1 rco"i^n1ec.- r t e G-( 12 ifo-i C.-cite-LI ?J A- n-1) C (1-£p t i4G 4 n ( �/ Ik Now /=vlLr t✓a4 G C.- CONTACT CONTACT INFORMATION OWNER NAME: g1 wt ury J) 441-Z0 6O Li SK - TENANT NAME(If Commercial): ^0) OWNER MAILING ADDRESS: STREET 9G 2'? /6)1-462 L d cn' CUL7C(( • STATE C.-)4 ZIP frZQS� OWNER PHONE: 1(IS--7S-3-79 OWNER EMAIL: 4-)/01 CONTRACTOR NAME: A9C14-7-11 1,2_20C CLCCT2GC_ L CONTRACTOR ADDRESS: STREET I2 O'f S /NC cC / CITY C�ac-r'-c STATE C 3/1-- ZIP 'fz o p CONTRACTOR PHONE: II-S.-37-7- 3277 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): "1"4-711/- 9,01.0-3— CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 0.27 PRIMARY CONTACT: E'OWNER ❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ZS-- 3 Z7—112-7 S'-CUC 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 lam authorized by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE -a �O) PERMIT# Z= - E I - G (/u1 Owner/Authorized gent Signature Date (Revised 10/12/2015)