7920 EVERGREEN WAY 2018-10-24 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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 vwwv.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2 V 4C C /'C cq BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: j9COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES IkNO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OFL WORK: /,r/i�c r�c �/ c /i A CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): �� o.v . Ao/j OWNER MAILING ADDRESS: STREET 75; Z O CITY G 7V_ STATE w�' ZIP / O OWNER PHONE: / 2 S 9.5'3 62- 97 OWNER EMAIL: CONTRACTOR NAME: /101.0- 07 /C.- Ae6/4r 4r— f 0�; C /1" c CONTRACTOR ADDRESS: STREET /2 `3 r yr /�c�f►i /�.✓ q 7 J! CITY 1150 t,/ STATE �4 ZIP / Z CONTRACTOR PHONE: 3.10 75-,71500 CONTRACTOR EMAIL: p w Cl v/,7 G C C a �i CONTRACTOR LIC.#(REQUIRED): Po ► n fC.' /y? cf c CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑ CONTRACTOR ❑OTHER(Please Specify) c / CONTAC AME: CONTACT PHONE: y Z S g 7L_ 4 the Y^/`/4 CONTACT EMAIL: Ojeo4/ 41) ggo ,� crC , e 0 AGREEMENT./hereby certify that 1 have read and examined this application and know the same 16be true and correct. All p ovisions of laws 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 PERMIT# E :�o3 - zZ Owner/Authorized Agent Signature Date (Revised 9/23/2016)