3121 TULALIP AVE 2026-02-05 - Laserfiche WebLink

Jul 21 2017 09:18AM HP Fax page 1 4110 • ELECTRICAL PERMIT APPLICATION +^' 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: 2 l 2,- \ V Lc l:,7 t J BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ti]SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: H-D rv\E ` ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ (D(J,' ' NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: "k t 7 ` \J\ck CONTACT INFORMATION OWNER NAME: ,\raF j- ,N,,y) *, , 1V.,i+ *c- i*ENANT NAME(If Commercial): OWNER MAILING ADDRESS: smut' .3 II 2, I -TA.)L�1 L l el- GITY V'[ •-C STATE I \J' 1 ZIP 9 t i 7.0 I OWNER PHONE: N 1 \ ` OWNER EMAIL: NiP‘ CONTRACTOR NAME: LI)IV\ - 1z2_,_RF- E'"� �(2 \C L. C CONTRACTOR ADDRESS: STREET L1�`)3 `55b l-}-\�� ll�1� } CITY ! ,N t , 2 S t-. �L s r- VL. STATE l/`'� Cti Li l!'� l zip CONTRACTOR PHONE:2c)l 'zoo 41r1(r,S (CONTRACTOR EMAIL: `v,\ne ck C c- \) ( ti CONTRACTO R LIC.#REQUIRE ( D)' ,CITY OF EVERETT BUSINESS LIC.#(REQUlR PRIMARY CONTACT: 0 OWNER K.CONTRACTOR 0 OTHER(Please Specify) I, f"� CONTACT NAME: CONTACT PHONE: '�L 20C) 9-1 loc [J 'K'A (\`�j k CONTACT EMAIL: C� \, AQREEME11:I 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 IC 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 WAC. r n 1 G r i G1ly of Everett Official Use Only .(., E U,1 ,� ; i?-../ i( -7 1 PERMIT# /� C ,(/iiLlk -1 .i I Owner/Authorized Agint Signatu'e Dat (Revised 9/13/2016)