117 FOREST CT 2016-08-22 - Laserfiche WebLink

Nov 16 15 03:09p p,2 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 4L 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: ) Fo r eS�- BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE. ❑SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $_ D/ NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable); DESCRIPTION OF WORK: — 7`� " ��,��•. tier CONTACT INFORMATION OWNER NAME(—j yf�. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srRetr � I f--U Q �rC� I -�� CITY C� ��•�-6 S-ATE OWNER PHONE-/ t J �Jq - i �] 1 OWNER EMAIL: CONTRACTOR NAME: &S y'yt 'A 6,a--f-i._" --,LA-Lk- CONTRACTOR -,L I/CONTRACTOR ADDRESS: STREET,,4-j CITY �� Y i 1 STATE 0CA— 21P•� � T CONTRACTOR PHONE./4j!5---336- 40A CONTRACTOR EMAIL: �C)►rC!S1�aVtti G' CUMC�cS I�� CONTRACTOR LIC.#(REQUIRED): 0[) CITY OF EVERETT BUSINESS LIC,P(REQUIRED)L4 a--�44 PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) CONTA SIIA CONTACT PHONE:4 J " CONTACT EMAIL: AGREEMENT.'T hereby cerW that l have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work wilf be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancer the provisions of any other state or local law regulahy7g construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and r comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 00 r PERMIT# E Owner/Authorized Agent ignature Date (Revised 10/12/2015)