2316 7TH ST 2016-08-31 - Laserfiche WebLink

�ECTRICAL PERMIT AF�.ICATION 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 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES if low volta e: FIRE ALARM? ❑ YES � NO ASSOCIATED BUILDING PERMIT # if a licable : DESCRIPTION OF WORK: �� F� C��i��'�GC� �I��';'�G`SC�I �;��o"4�I; f��JI�C@ L�il-%�fOt�f�C��;C� i2C��I�S ��.�`�� ��it��cs; ��c! smnke �iarm� ''��; � �� (�c� ��d v��rir� �� r�eces�r�r �� , � ' � - Y; bri�� dweEleng up �� 't;'l,�i �^nif'� f�s��:.}� �� ';(��J�'. CONTACT INFORMATION �� ° � ''��`� ��xg�� TENANT NAME If Commerclal : OWNER NAME: "�� OWNER MAILING ADDRESS: sTReer � 611 19th 5tree� p�� . �} r•�ja� > � �. _� CITYf`�tlt��f:LC STATE�'.t"'�`' ZIP'`{�P��..I @ OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �='f�'�"�G�r� CONTRACTOR ADDRESS: sTReer CITY STATE ZIP CONTRACTOR PHONE: � �L�`�<�-''� � CONTRACTOR EMAIL: ' ''c ��-�' �`'�«� - CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: � OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE:��i,��;�'_.,<; ��j�� ��€-i ��:.��`v�CJ`r CONTACTEMAIL: ��C�iiwz�C33'?(t';'i'�F�c:,.£�_•"_:°i','; AGREEMENT: T hereby certify that l have read and examined this appJication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work wil! be completed whether specified herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provisions of any other state or local law regulating consiruc�ion or the perlormance of construction. That I am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. � Agent Signature City of Everett Official Use Only FEE � � I �� n.� PERMIT # � E ��j� ��j (Revised 10/12/2015)