1414 SILVER LAKE DR 2016-10-05 - Laserfiche WebLink

� ECTRICAL PERMIT A�LICATION 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 PROJECT ADDRESS: } �i' PROJECT SITE INFORMATION _ � BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: USE OF BUILDING: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2� �j NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES � NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: -R � L � L� CONTACT INFORMATION OWNER NAME: %V (/�, � TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReeT I� f �� L S� �� GTY STATE �J � ZIP (f !�'-� � OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: � (� CONTRACTOR ADDRESS: sTREEr � � (�� U CITY � �— STATE (jj ZIP CONTRACTOR PHONE: Z- r�� 7�?S CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): � �` CITY OF EVERETT BUSINESS LIC. #(REQUIRED): L- ,j PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: � �,:�/ t� CONTACTEMAIL: AGREEMENT: T hereby certify ihat 1 have read and examined fhis application and know ihe same fo 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 fo give authonty to violate or cancel the provisrons of any other state or local law regulating construction or the performance of construction. Thaf I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Cont�actors Law 18.27 RCW and 296.200 WAC. Owner/Authorized Agent Signature Date � City of Everett Official Use Only FEE L �o -`� PERMIT # E ��0�-6�� (Revised 10/12/2095)