747 75TH ST SE THE LAKESIDE 2020-02-19

ELECTRICAL 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 I.t PROJECT SITE INFORMATfON PROJECT ADDRESS: BICI . D 75th St. SE Everett, WA 98203 BUILDING AREA(it residential,new construction,remodel,or addition) SF BUI�DING TYPE: ❑ SFR-DETACHED ❑ SFR-ATi"ACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS:N/A ❑COMMERCIAL USE OF BUILDING: MUItI-FaI�T11I Residential ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ HOO.00 NUMBER OF DEVICES (if low voltage): � FIRE ALARM? �YES ❑NO ASSOCIATED BUILDING PERMIT#(if a licable : �escR�PT�oN oF woRK: Provide dedicated 120V circuit for new fire alarm panel. CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): �, � OWNER MAILING ADDRESS: sraEer cilv srnre zia OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �OIlC1SOtl EI@CtfIC, �t1C. CONTRACTOR ADDRESS: sTaEET 11816 116th Street N E �,T,. Kirkland STATE WA Z,P 98034 CONTRACTOR PHONE:4Z�J-H2�-$ZZF) CONTRACTOR EMAIL: )OI1Clh@JOIIIlSOC1EI@Ct.COCT'I CONTRACTOR LIC.#(REQUIRED): �O�'lllSe1384CU CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O3�435 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 4.2�j-]66-7�$4 Larry Watson CONTACT EMAIL:�a� w@johnsonelect.com AGREEMENT:1 hereby certify that I have read and examined this application and know the same to be true and correct. All provisrons of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construcfion or the performance of construction. That I am aufhorized by the owner of fhis property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296200 WAC. City of Everett Official Use Only � �' PERMIT# �'��C �_ � c �� E ��"� b -- � f��- l ner/Adthorized Agent Signature Date (Revised 9/23/2016)