5428 LOWELL RD 2016-09-30 - Laserfiche WebLink

425-252-1666 c.m.heating 12:52:20 12-11-2015 3/3 9 10 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwa.gov J www.everettwa.gov/permits PROJECT S1TE INFORMATION PROJECT ADDRESS: qZpp L-o\,Nd I 5e BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED /K7 SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-##OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL. APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 5O NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: -Rkrn oc-e 1�n CONTACT INFORMATION OWNER NAME: Mitt w i lS d kQQ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTT��r 5423 LOV.,/7e( T-6. Se CrTY re STATEWA ZIP I O3 OWNER PHONE: L1ZS X5.5 - Dot I g OWNER EMAIL: CONTRACTOR NAME: r- CONTRACTOR ADDRESS: S-MEET jW5 1"]adw .rn EvefeW STATE WA ZIP 9 8 20 CONTRACTOR PHONE:42-5 (P p&(p 1CONTRACTOR EMAIL: deblbie D ernkeain 9. CovY1 CONTRACTOR LIC.##(REQUIRED): 1Jm H S-7Z DN I CITY OF EVERETT BUSINESS LIC.#(REQUIRED): IO Q'? PRIMARY CONTACT: ❑ OWNER A CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425 251 (0&64 ve bb�-e Ua ue s 1CONTACT EMAIL: eWe om he Q-hn .corr AGREEMI<NT.'Thereby certify that/hava road and examined this application and know the same to be trve and correct. All provisions of taws and ordinances governing this type of work wJ71 be completed whetherspaclfied heroin or not. The granting of a permit does not prasume to give authorily to violate or cancel the provisions of any other state or local law regulating construclien or Ilia parformanca of construction. That I am authorized by the owner cf this property to perform the work for which application is made and I comply with Ilia State Contractors Low 18.27 RCW and 2176.200 WAC. City of Evorett Ofctal Use Only FEE A), PERMIT# OvvnerlAuthorizod A161 Signature Data (Revised 10/12/2015)