2430 BAKER AVE 2016-08-17 - Laserfiche WebLink

OECTRICAL PERMIT A14LICATION 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: Z H 3(? Pc7c 6v Aj _ BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED M SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: �- �� U o" ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): j FIRE ALARM? ❑YES IR NO ASSOCIATED BUILDING PERMIT# (if applicable): �q DESCRIPTION OF WORK: asc // 1Yly� L,,-% Gra�. eco' C,PA Cle ' CJD fa well I CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: II 11 OWNER EMAIL: CONTRACTOR NAME: t l4-'4-0"e t�&'� I L CONTRACTOR ADDRESS: STREET D. e e,x 23-25— CITY L 'V1' W c� t) C/` STATE W�'"T ZIP CONTRACTOR PHONE: t}Zj -2 3 )- 2'46 L 1CONTRACTOR EMAIL: ,5 as 4-1 Le ✓Y7-1 L,* CONTRACTOR LIC.#(REQUIRED): LF-13F-L 16 cl P'"7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):053 535- PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: W v_T Q)b�Zy CONTACT PHONE: Zj — �iZ CONTACT EMAIL: W itee fe y✓lst, ( Cci, AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions diaws 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE AA PERMIT# Owner/Authorized Agent Signature Date (Revised 10/12/2015)