2516 W MARINE VIEW DR APPLIED TECH 2016-08-24

� �_ • �LECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: �,�j—�� /�/ �S'f �;✓ � . `P�ci � 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: $ pZ�� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ,�-NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: C �<. c� ` CONTACT INFORMATION OWNER NAME: �G iyj� � TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTtzEEr " ' n > CITY ' STATE � ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: sTReer CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT: T hereby certify that / have read and examined this application and know the same to be true and correcf. All provisions of laws and ordinances governing this type of work will be comp/eted whether specified herein or not. The granting of a permit does not presume to give authority to violate or cance/ the provisions of any other state or local law regu/ating construction or the performance of construction. That I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. �.-f��.� . -. ..- . . - -� ._ - City of Everett Official Use Only FEE � �� 5� PERMIT # E � 2- � (Revised 10/12/2015)