717 GRAND AVE 2016-08-22 - Laserfiche WebLink

12113%2015 23 : 00 #7677 P. 001/001 0 is ELECTRICAL PERMIT APPLICATION CITY OF EVERFTT PERMIT SFRVICES OOL 3200 CEDAR STREET, FVFRETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 f (E) everetteps@everettwa.gov j www.everettwa.gov/permits M1R ^ RAT ttht, a3R1 ,,Pl;, t.tE t PROJECT ADDRESS: / /`(IO BUILDING AREA(if residential, new construction, remodal, of addition) OF BUILDING TYPE: ❑SFR-DFTACHED D SFR-ATTACHE=D ❑ DUPLFX 0 MUI-TI-FAMILY-#t OF UNITS: Q COMMERCIAL USE OF BUILDING: .x', , �;yi l ;.��I,. �.. yiv �: L, t Ial 1 ` ,`,.•l'•'," _ WT +tlk a ;� t�,�'�. .�Jlr �, CONTRACT PRICE OF WORK: $ 100e- _ NUMBER OF DEVICFS (if low Volta e): FIRE ALARM? Q YES 0 NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: C t9(1 t ^ ,M, � Klil�4',RR;,Q!P� T1'�S�31Rla!t-;\ OWNER NAME: IDN"A SA44MOM TENANT NAME If Commercial): OWNER MAILING ADDRESS: STRea'r o cn-y STATE ZIF OWNFFZ PHONE: OWNER EMAIL: CONTRACTOR NAME: f H CONTRACTOR ADDRESS: STREET ,f! CINrmrAeff— STATE LI& ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRFD) CITY OF EVERFTT 13USINESS LIC.#(Rl-QUIRED): PRIMARY CONTACT: ❑OWNER © CONTRACTOR 11 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 412—f J-b t0 CONTACT EMAIL: AGREEMENT.,7 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 giva authority to violate or cancel the provisions of any other state or local law regulating 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 Contractors Law 18,27 RCW and 295.200 WAC. City of Everett official Use Only FEE PERMIT# 71""thorizod Agent Signature Date (Revised 90/12/2015)