117 FOREST CT 2016-08-22 - Laserfiche WebLink

&ECTRICAL PERMIT AgiLICATION Ey CITY OF EVERETT PERMIT SE VICES 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: I"n .��, I �� % { f L 1. ! � d 0 ..� ; � C BUILDING AREA(if residential, new construction, remodel, or addition) Y 5 SF BUILDING TYPE: SFR-DETACHED FR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES M NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: 7 f �,�� / TENANT NAME(If Commercial): OWNER MAILING ADDRESS` STREET CITY STATE (., V. 4� ZIP -7 OWNER PHONE: `I ZS S��" I / OWNER EMAIL: CONTRACTOR NAME: I tEpii i44— r--L-r /0/ C CONTRACTOR ADDRESS: STREET CIN l�v�'`L IIT -• STATE C" = ZIP CONTRACTOR PHONE: S(cn - i"r�? 7 1 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): - FI �Z1l �. �( J� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ' PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 3C.d < 3:�C.7 CONTACT EMAIL: (/LAetv^f_,S'0'i, (evoe=l'. (4-c -6c r n<�l��l AGREEMENT:T hereby certify that I 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 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 FEE r2o PERMIT# ` E tG [ H -2,I Owner/ uthorized Agent Si,bnature Date (Revised 10/12/2015)