5030 CREST LN 2016-08-03 - Laserfiche WebLink

ELECTRICAL PERMIT A_LICATION 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 PROJECT ADDRESS: 0-SO Chi 4` BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: Z" ,' ' ;.v ;� '.;� �, �` �" ��r C��,►�7��•,�il�l�,l�+l� '�1�� a�� 1��c w � � '� `�a, s �� CONTRACT PRICE OF WORK: $ a0U NUMBER OF DEVICES if low voltage): FIRE ALARM? 0 YES EANO ASSOCIATED BUILDING PERMIT# if applicable): 00 5 DESCRIPTION OF WORK: - OWNER NAME: TENANT NAME if Commercial): OWNER MAILING ADDRESS: STREET CITY C%l.._ STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: e� CONTRACTOR ADDRESS: STREET CITY PA,a L STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: � s CONTRACTOR LIC.#(REQUIRED): �j-(� CITY OF EVERETT BUSINESS LIC. (REQUIRED): PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACTInNAME: � CONTACT PHONE: 22— '"i`►'"Pi �4 /&'U1ZL_d ACT EMAIL: AGREEMENT.,Thereby certify that 1have 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE AA 10�°0 PERMIT# EW Owner/Authoriz gent Si n Date (Revised 10/12/2015)