2621 GRAND AVE 2016-08-22 - Laserfiche WebLink

MAR-08-2016 08:36 ELECTRI—CITY 425 672 6799 P.01/01 9 (9 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everett.va.gov www_everettwa.gov/permits .......... ROJE T:j_',fT. AN MAT �FPIR Pon PROJFCT ADDRESS: A)19 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE; IP/SFR-DETACHED DSFR-ATTACHED LIDUPLEX LJ MULTI-FAMILY-#OF UNITS, El COMMERCIAL IUSE OF BUILDING: d. 04 MAT,� ,d,0' ............ I'll "31 I "I 54121�!�"��H, "I !1I 1��'R CONTRACT PRICE OF WORK $ SDU NUMBER OF DEVICES if low voltage): FIRE ALARM? 11 YES I-] NO ASSOCIATED BUILDING PERMIT V if appficable : DESCRIPTION OF WORK* 0200,9 \j T pq �4 NFOR'A OWNER NAME: TENANT NAME If Commercial): OWNER MAILING ADDRESS; STREET '5"�-en r— 116 4j;P1e.;-- STATE ZIP OWNER PHONE: CITY ----OWNER EMAIL: CONTRACTOR NAME: .01 CONTRACTOR ADDRESS: STREET 'Wqa" ciry MakllZIP fte) CONTRACTOR PHONE: CONTRACTOR EMAIL. Q Cam CONTRACTOR LIC.#(REQUJRED)-!,C��Jm.&--f ICITY OF EVERETT BUSINESS LIC.#(REQUIREDI�va�/-3 PRIMARY CONTACT: Cl OWNER 7CONTRACTOR E]OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -eo7f 7 GL//Pi Bo'k-P-1- CONTACT EMAIL: AC,REEMENT.,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 typo of work will bo Cornolotod whothot SpoCifiodhoroin or not. Tho granting ora pormil does not prosumo to give authority to violate or cancel(Po provisions crony Other state or loco/law regulating construction or the performance of Construct ion. Tj).,3t 1,9m authorized by the owner of this property to perform the work for which application is mads and i COMPlY with the Slato COF*Oclors Law 16.27 RCW and 296,200 WAG, City of Everett Official Use Only FEE PERMIT 4 E Ow6r/ thorlzed Agent Signature Date (Revised 1011212015) TOTAL P.01