407 47TH ST SE 2016-06-03 - Laserfiche WebLink

Or477. E CTRICAL PERMIT APF--CATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits • PROJECT SITE INFORMATION 1 PROJECT ADDRESS: n 111A- Si ' 9&DO3 BUILDING AREA(if residential,new construction,remodel, or addition) SF BUILDING TYPE: CI SFR-DETACHED 'SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: • ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ , Q NUMBER OF DEVICES (If low voltay�e : FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(If applicable : DESCRIPTION OF WORK: CiA4fidl ( i,g wAiS D CONTACT INFORMATION OWNER NAME: 101•J Ke(A/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srae£r 4./ Si Se. ,1 J p Q Q /aY� c rry �?�" �.i� STATE Y V 7 ! zip J[� 3 OWNER PHONE: ' OWNER EMAIL: CONTRACTOR NAME: Cm H 41.6.9 CONTRACTOR ADDRESS: sTREET 4 : fbadw EVefett STATE WA ZIP 9 z x.01 CONTRACTOR PHONE: 2 sa te.PII G CONTRACTOR EMAIL: debbi.e€ or1h8Mfr'l ' . cPt/YI CONTRACTOR LIC.#(REQUIRED:{,r �#f m�i S Z D t� CITY OF EVERETT BUSINESS LIC.#(REQUIRED?: at (O O r PRIMARY CONTACT: El OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Li-2,5 254 („6,64, yebb;-e C3du.ers CONTACT EMAIL: oebbie63col hecrh 9 •Cory AGREEMENT:Thereby certify that I have read end examined this application and know the same to be true end correct. All provisions of laws end ordinances governing this 'ype of work will be completed whether specified herein or not. The gmnling of a permit does not presume to give authority to violate or cancel the provisions of any other slate or ocal 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 :empty with the Stale Contractors Law 18.27 RCW and 288.200 WAC. City of Everett Official Use Only FEE #1 't j PERMIT# • DthibiLti a I 1L5 E I 6201- I O G9 )wnor/Authorizod A n3 Signature f' D to (Revised 10/12/2015)