2830 CEDAR ST 2016-08-17 - Laserfiche WebLink

WCES 4253223792 p.1 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 4L 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.govlperm its PROJECT) SITE INFORMATION PROJECTADDRESS: BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑DUPLEX 13 MULTI-FAMILY-#OF UNITS:_ ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ZT, j c)o NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES D,NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: . CONTACT INFORMATION OWNE=R NAME: --Or-n f TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET 7 a I Sfi Pi ci-Y f-ti H� [�o(�CI STATE L,"-\ ZIP q;J a OWNER PHONE; �,'? - o Z� OWNER EMAIL: CONTRACTOR NAME: j.:c ,��, 5� r(.✓` G G'� I �l� CONTRACTOR ADDRESS: STREET �i Z5 i, CRY J�I,;�G�0—'D0 � 4 STATE �/fr�'' ZIP ✓�-' ,l a CONTRACTOR PHONE:BIZ-`- -Q 3O ! �f S CONTRACTOR EMAIL: t y -�Ga G - 5 !vl i"��t + ��S•C��"t CONTRACTOR LIC-M(REOlJIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER t,0LCONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME:, CONTACT PHONE: L `SL 7vrr tifS CONTACT EMAIL: AGREEMENT.•Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of Jaws and ordinances governing this type of work will be completed whetherspeci6ed heram or not. The granting of a permit does not presume to give aulhority to violate or cancel the provisions of any other state or local law reguia ling construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and I comply with the State Confractors Law 9$.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE `� PERMIT#