1500 BAKER AVE 2016-08-17 - Laserfiche WebLink

CTRICAL PERMIT APf_ICATION CITY OF EVERETT PERMIT SERVICES 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 PROJECT ADDRESS: � X V� F V I w A q� BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED �bFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ')bvi v-\_ p�iYZ°G� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK•. $ NUMBER OF DEVICES (if low voltage) , FIRE ALARM? ❑ YES 7N 0 ASSOCIATED BUILDING PERMIT# if applicable : DESCRIPTION OF WORK: 2u) CONTACT INFORMATION OWNER NAME: F)1_0 mien //o'/ TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET /0/✓� ax4kc" 7�_� �1 CITY (�/1 l/tJ STATE WA ZiP 1(� OWNER PHONE: 425 Z52 _20,30 1OWNER EMAIL: IVIA CONTRACTOR NAME: /fJ� CONTRACTOR ADDRESS: STREET CITY /� Sys STATE �� J ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): f N (�0Sj5Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR THER(Please Specify) CONTACT NAME: �Q / CONTACT PHONE: 4 l L CONTACT EMAIL: �l�l � �ji�s �/� �/j��j� C071t_� AGREEMENT.-Thereby certify that I have read and examined this application and know the same to be true a d correct. All provisions of laa 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/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 PERMIT# E �dZ _ OS� Own uthorized Agent Slgrfature ate (Revised 10/12/2015)