3412 OAKES AVE 2016-08-25 - Laserfiche WebLink

�,.ECTRICAL PERMIT A�LICATION 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: � � Z � L � � 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: CONTACT INFORMATION OWNER NAME: �" ��,. ' � TENANT NAME (If Commercial): r OWNER MAILING ADDRESS: sTReeT Q•, '� CITY STATE ZIP ��✓� OWNER PHONE: C� ) OWNER EMAIL: CONTRACTOR NAME: C �L f �,f' � �� ,� CONTRACTOR ADDRESS: sTREET <�( /i CITY STATE �,, ZIP L,/ � CONTRACTOR PHONE: �"�� J �-,J�° Z CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): � ' ;f % ` CITY OF EVERETT BUSINESS LIC. #(REQUIRED): [�/ " � PRIMARY CONTACT: ❑ OWNER , CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: "� C� � � � CONTACT EMAIL: AGREEMENT.� T hereby certify that 1 have read and examined fhis application and know the same to be frue and correct. All provisions of /aws and ordinances governing this type of work wi116e completed whefher specified herein or not. The granting of a permit does not presume to give authonfy to violafe or cance/ the provisions of any ofher state or local law regulating construction or the performance of construcfion. That I am authorized by the owner of this property to perform the work for which application is made and I comply wifh fhe State Contractors Law 98.27 RCW and 296.200 WAC. Own�PtFi�l�iorized Agent Signature Date Ciiy of Everett Official Use Only FEE � �� 0 PERMIT# E � � " I�� (Revised 10/12/2015)