11311 19TH AVE SE BLDG D 2025-09-30

is li is ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov www.everettwa.gov/permits 7 AM ffljswjjP�tQJECT PROJECT ADDRESS: 11311 19th Ave SE Everett, WA. 98208 ' Building D BUILDING AREA(if residential,new construction, remodel,or addition) BUILDING TYPE: L1 SFR-DETACHED El SFR-ATTACHED El DUPLEX El MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Apartments A5. 2N . Lr=CTkl ZATION,INFORMATION� CONTRACT PRICE OF WORK: $ 480 NUMBER OF DEVICES (if low voltage): FIRE ALARM? El YES 0 NO ASSOCIATED BUILDING PERIMIT# if applicable): DESCRIPTION OF WORK: Extend 20amp circuit and add outside light fixture CONTACT.SNF MAT[&*. OWNER NAME: Bluwater Apartments TENANT NAME If Commercial): Amber OWNER MAILING ADDRESS: 111EIT 11311 19th Ave SE cny Everett STATE WA ... 98208 — OWNER PHONE: 425-357-8400 TOWNER EMAIL: CONTRACTOR NAME: Active Engineering/Neighborhood Electric CONTRACTOR ADDRESS: 1T11E1 6605 200th St SW CHY Lynnwood STATE WA zia 98036 CONTRACTOR PHONE: 425-776-8119 1CONTRACTOR EMAIL: admindesk@activeengineering.net CONTRACTOR LIC.#(REQUIRED): ACTIVE*08811/lS [CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 026248 PRIMARY CONTACT: 10 OWNER 0 CONTRACTOR El OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-357-8400 /206-571-7965 AMBER / LUCAS CONTACT EMAIL: AGREEMENT.,I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of taws 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 WAC. City of Everett Official Use Only PERMIT# 21 Ownerlikuthorized Agent Signature Date (Revised 9/2312016)