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7826 TIMBER HILL DR 2016-08-31
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7826 TIMBER HILL DR 2016-08-31
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Last modified
1/12/2017 10:46:14 PM
Creation date
8/31/2016 9:27:55 AM
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Address Document
Street Name
TIMBER HILL DR
Street Number
7826
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�..ECTRICAL PERMIT A�LICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />PROJECT ADDRESS: � 1� � <br />BUILDING AREA (if residential, new construction, remodel, or addition) SF <br />BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL <br />USE OF BUILDING: <br />ELECTRICAL APPLICATION INFORMATION <br />CONTRACT PRICE OF WORK: $ <br />NUMBER OF DEVICES (if low voltage): <br />FIRE ALARM? ❑ YES ❑ NO <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />DESCRIPTION OF WORK: 6''� b v� —� G, �2 + <br />CONTACT INFORMATION <br />OWNER NAME: � �� TENANT NAME (If Commercial): <br />� <br />OWNER MAILING ADDRESS: srReET � ,'�Y� � �/ � ' <br />CITY �U'� `I STATE �1 O� Q\ — ZIP V Q <br />OWNER PHONE: � � � G/6 ' OWNER EMAIL: <br />CONTRACTOR NAME: <br />CONTRACTOR ADDRESS: srReeT <br />CITY STATE ZIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): <br />_ _ _ _ _ . _ _ _ _ _ <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAIL: <br />AGREEMENT: T hereby certify that ! have read and examined this application and know the same to be true and correct. Al/ provisions of /aws and ordinances governrng this <br />type of work will be completed whefher specified herein or not. The granting of a permit does not presume to give authonty to violate or cance/ the provisions of any other state or <br />local law regulating construction o� the performance of construction. That I am authorized by the owner of this property fo perform the work for which application is made and I <br />comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br />� <br />�����o�� <br />Owner/Authorized Agent Signature Date <br />Ciiy of Everetf Official Use Only <br />FEE <br />l� ��0���� <br />PERMIT# <br />E � � �o Z-c��3 <br />(Revised 10/12/2015) <br />
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