1802 75TH ST SW 2016-09-15 - Laserfiche WebLink

04E7r .ECTRICAL PERMIT A 4LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: , '7✓ 7 '±$ C) BUILDING AREA(if residential, new construction, remodel, or addition) /ti'/j'J SF BUILDING TYPE: El SFR-DETACHED�� I=1 SFR-ATTACHED El DUPLEX I=1 MULTI-FAMILY-#OF UNITS: COMMERCIAL V USE OF BUILDING: 1 T1(C.S ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ T3 7, /4 2.. CJ NUMBER OF DEVICES (if low voltage): -- FIRE ALARM? ❑ YES Il NO ASSOCIATED BUILDING PERMIT# (if applicable): -- DESCRIPTION OF WORK: 1-14// Z A-4 iia r..1L= iry, ( ,,r,PA 11 hi_ � &'U`1I it49 e1, //7 c/ 11ns•I°L CONTACT INFORMATION OWNER NAME: 5 ,,A 6,9,1 t1A )) lit D TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Z 3 it Co/•41,h12;1.. ,tls-C CITY it'Jc'f t I1- Est STATE ZIP if?'"c' OWNER PHONE: 9 73-- 7's j- &III(0 OWNER EMAIL: G-r p_esc, 0 S .iUPmy), 6.i44---- CONTRACTOR NAME: Ursa /kq/ Jr I t' i CONTRACTOR ADDRESS: STREET i/c�� 'e,(yYk ®ori CITY /t/C4 f r STATE ,A ZIP re/2-0 5 CONTRACTOR PHONE: U----(10- On .L CONTRACTOR EMAIL: cc L)# V(let Yv/G , {ii-. CONTRACTOR LIC.#(REQUIRED): V 4/r jr"k 114/X1/'4 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O 7.Z5T PRIMARY CONTACT: ❑ OWNER 5kCONTRACTOR ❑ OTHER(Please Specify) CONT CT NAME: 7 CONTACT PHONE: q .Z 4- 7.2,2 - 7 i4 7 L i �1 p- /) /-. CONTACT EMAIL: 5&e d %p'1 tie I ec).-1--1i,r eon AGREEMENT:T hereby certify that/have read and examined this application and know the same to be true and correct. All provisions 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 construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 1 7 q) - °° PERMIT# C. 6/zVE V(120 — 11-4D Ow r/Authorized gen Signature Date (Revised 10/12/2015)