4908 DOGWOOD DR 2016-08-03 - Laserfiche WebLink

—ECTRICAL PERMIT Am"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 SITE INFORMATION': PROJECT ADDRESS: BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED 11DUPLEX ❑ MULTI-FAMILY-#OF UNITS: 11COMMERCIAL [USEF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ C) NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION . OWNER NAME: vi TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET Wood!tet L - CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: -� CONTRACTOR ADDRESS: STREET CITY STATE 1 ) ZIP CONTRACTOR PHONE: 5 ' Cl l CONTRACTOR EMAIL: 1&wn iA jQe I 9J1 CONTRACTOR LIC.#(REQUIRED)- Z51 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):(/ PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Qa5— --3 An LW LJ r CONTACT EMAIL: AGREEMENT.Thereby certify that l have read and examined this application and know the same to be true an c rrect. All provisions of lAys 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE Loo e°� PERMIT# 02-- 1 '&�e Lql Owner/Authorized Agent Signature Date (Revised 10/1212015)