8823 HOLLY DR 2016-08-05 - Laserfiche WebLink

From Commercial Fire Protection Inc 1.360.848.1072 Wed May 11 07:18:53 2016 PDT Page 2 of 2 0 • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT,WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits © PROJECT SITE INFORMATION %, V o PROJECT ADDRESS: 6 L3 Oki- E vc*-e-T-T t JA '96Z-08 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: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 00 c.:-- NUMBER .`NUMBER OF DEVICES(if low voltage): FIR17 ALARM? ' YES ❑NO ASEtOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 'Re-19 LA-C- Cp eT O CONTACT INFORMATION OWNER NAME: l a/VC�Csylfylr✓s�r /A/e5wi TENANT NAME If Commercial): OW14ER MAILING ADDRESS: STREET jib A` A 5- sem/ CITY T;- STATE OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �o/r�r+rC/L'/�2 J /rl�/s� tc d z1 CONTRACTOR ADDRESS: STRFET CITY SWE zr 73 CONTRACTOR PHONE: So-' -86,9 B K6'S- CONTRACTOR EMAIL: rO PJ g C.l,/�, CONTRACTOR LIC.#(REQUIRED): eA/ 9y&I—C) CITY OF EVERETT BUSINESS LIG.#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) _., CONTACT NAME: l CONTACT PHONE: S0 ry &r-, S I�c`�c�-� CONTACT EMAIL: Ko'-j CAP, rz vyn , (c ,-I, AGREEMENT T hereby cer*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 speclfled herein or not. The granting of a permit does not presume to give authority to violate or cancel the provislons 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 Caw 1827 RCW and 296.200 WAC. City of Everett Oficial Use Only FEE PERMIT# E Owner/Authorized Agent Signature Date (Revised 10112/2015)