8909 10TH DR SE 2016-10-14 - Laserfiche WebLink

�,�►� ��,� ,�.ECTRICAL PERMIi AF�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 SITE INFORMATION PROJECT ADDRESS: �', `� C.% `7� —� G' �'� �r`�, 5 �-� ' BUILDING AREA (if residential, new construction, remodel, or addition) �� SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: `j-�p r^e�� ,� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ � NUMBER OF DEVICES (if low voltage): ��-,�=(c� r,: �fs�c,-�,c=� I w,��{.E��( -�.�y� j g.,,,.�<,:!> -ti; �-:t FIRE ALARM? ❑ YES �-EVO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: d��..<..--_ _e.C.�' C��.� -.-. `-�� ti.-.� .� `f �c c�� G�'L � -f- , �f-� = t�-c�_.:> �.,�,, �-I-� ��1-� 5 �� .�--'#-� r� '� ��t 5 L-.� c � . CONTACT INFORMATION OWNER NAME: /-t-1"! r=y--c- ��c( c� TENANT NAME (If Commercial): OWNER MAILING ADDRESS: s7uEET �d `J i1 �f -/�z �;r- .S.` CITY � Vl-��-ti.'.`"1 STATE �(.�� ZIP /�� L $_! 7 _:. OWNER PHONE: �-[ �J-5 -_5 l�-�z 4 I y�5 3<, OWNER EMAIL: CZ r- !-E�ti� �� ci �(„ C�`_ CONTRACTORNAME: �rI � N—t�C� CONTRACTOR ADDRESS; s�EeT �1 D l—f ��L O� S�• ClTY �y . ^.�,� STATE �� ZIP �� CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT: T hereby certify fhat / have read and examined this application and know the same to be true and correct. All provisions of /aws and ordinances governing this type of work will be completed whether specrfied herein or not. The granting of a permit does not presume to give authorify to violate or cance/ 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 1 comply with the State Contractors Law 98.27 RCW and 296.200 WAC. Owner/Authorized Agent Signature �- I �`-1 Date City of Everett Official Use On/y FEE �� PERMIT # E o �� (Revised 10/12/2015)