501 74TH ST SW 2016-10-19 - Laserfiche WebLink

�ECTRICAL PERMIT AP�.ICATION 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: 501 74th St SW BUILDING AREA (if residential, new construction, remodel, or addition) 2200 SF BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ReSld@fltlal ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 950 NUMBER OF DEVICES (if low volta e: 1- Thermostat FIRE ALARM? ❑ YES NO ASSOCIATED BUILDING PERMIT #(if applicable): M1608-089 DESCRIPTION OF WORK: Install wiring for 40a AC Unit and thermostat for existing system CONTACT INFORMATION OWNER NAME: Cheryl Vander Pol TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srReeT 501 74th St SW cirv EVefett srAre WA ZiP 98203 OWNER PHONE: 425-387-0760 OWNER EMAIL: cherylh@ymail.com CONTRACTOR NAME: Eagle Pipe & Mechanical CONTRACTOR ADDRESS: srREET 54 Seven Sisters Rd c�rv Port Ludlow STATE �NA z�P 98365 CONTRACTOR PHONE: 206-765-6851 CONTRACTOR EMAIL: eaglepmwa@gmail.com CONTRACTOR LIC. #(REQUIRED): EAGLEPM841 M9 CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 054148 PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: AIISha CONr,4CT PHONe: 206-765-6851 CONTACT EMAIL: eaglepmwa@gmail.com AGREEMENT. T hereby ceRi(y that I have read and examined this appficatron and know the same to be true and correct. Ali provisions of laws and ordinances goveming this type of work wrll be completed whethe� specified herein or not. The granting of a permit does not presume to give authority fo violate or cancel the provisions of any other state or local law regulating constructron or the pertom�ance of constructron. 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. 08/29/2016 Owner/Authorized Agent Signature Date City of Everett O�cial Use Only FEE �� PERMIT # E � g �� - (Revised 10/12/2015)