3416 BELL AVE 2016-07-28 - Laserfiche WebLink

Mar 2516 04:56a VickieHtf 914838 p,1 C`-4“- OrE77 ELECTRICAL PERMIT APPLICATi Lfy-3052 -277 CITY OF EVERETT PERMIT SERVICES c A r' 3200 CEDAR STREET, EVERETT, WA 98201 (F)425-257-8810 ( FAX 425-257-88571 (E) everetteps@a everettwa.gov J`www.ever C 4 4" PROJECTySITE INFORMATION - - - - - .- .- PROJECT ADDRESS: _ k,3 l> ` ,re-rJ� I ".d -e- BUILDING AREA(if residential;new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED .Z SFR ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: `-tL �- ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ A 2,00t O©_ ' NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YESNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 116 J,`Cs el,.. I CONTACT INFORMATION OWNER NAME: l` (JE 6C--)1e.SeAti 10 TENANT NAME(if Commercial): • OWNER MAILING ADDRESS: eLVdelric, FAQ�Q A d _ED cw F . (kJ 1 STATE FY (ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Id lie C.) eefi. • CONTRACTOR ADDRESS: STREET 7PDja-C b- '& f/J)//��j CITY �-�l IT- STATE t e r 1 ,� D IU4I r �3 4 (CONTRACTOR EMAIL: ') U)i F knelt"r ....)/..k.941 zb/ia 1 P ip 9,82d6 2 t CONTRACTOR PHONE: 'CONTRACTOR LIC.#(REQUIRED): L , 'j I '�1 rte! -:. .. . 'CITY OF EVERETT BUSINESS L. #jREQuiRE .,. ._ %� PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) CONTrCT NAME: CONTACT PHONE: 0 .- 2 �,..Lt}�3 C • \,, ��.'2 Oil To tJ 1Q I `-Gdv-vv ,,,v]_ CONTACT EMAIL4 N )€ed ma_Vt 11 E) i,c�t i b/ r1, AGREEMENT T hereby certify that 1 have read and examined this application and know the same to be true end correct. Al!pprovisions 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 ragulating 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! comply with the State Contractors Law 18.27 ROW and 296.200 WAC. City of Everett Official Use Only 1 FEE 4bo3DO I '`--( to.tize—e_ 6 a p/7 ,fr/471.--- '3---25--//_- /- ' ;' ,aix, PERMIT# Owner/Authorized Agent Signature LD - (//b Date (Revised1 90/12/2015)