6016 DEXTER AVE 2016-08-29 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 ( FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ,5' BUILDING AREA(i`residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED C7 DUPLEX ❑MULTI-FAMILY-#OF UNITS: © COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $2 NUMBER OF DEVICES iif lav✓voltage): FIRE ALARM? ❑YES XNO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: �c S� j `tZ_ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: CITY (J STATE 21P OWNER PHONE: 4mt-2-5"4;(C-'— OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: sraeeT CONTRACTOR PHONE: .- - CONTRACTOR EMAIL: , -� CONTRACTOR LIC.#(REQUIRED): -�Y 1G1"� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): -71 PRIMARY CONTACT: ,,OWNER C7 CONTRACTOR 13 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4�-tvs 9-7&7--Cf' t { CGU CONTACT EMAIL: RG�� ariT Fed}° er f t at l nave read anti exam;�ec lfiis ao4)r s .n and .n .�r G e sa=ns to o�true gnu cor ect, Ai e C ¢ •'oPc of f is anv o,dr�aacee 9 ve nmio r'3r dype_r�.,,rk ay.t�h.,co.-.p'eleW v.hetner sceciireu ne,ein or not, Tf7s yr,,,t,,g of a permrt o`oas net prey,rn..to g::e aothorit:-to uo.at€cr ca-7601 the pro>sions of aar atf., �t,_t�nr oca7 taw regulating construction or the pe fo mance of construction. That I am authorized by the owner of this property to perrorm 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 Offie,'at Use Only FEE n I PERMIT 4 —71 7/-Z,,c 6- E OwAer/Authorized Agent Signature Date 'Revised 10f12/2015)