2815 BAKER AVE 2018-09-24 - Laserfiche WebLink

PLECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATION USBUIPROJECT ADDRESS: 15- gc,�L-e ti' 1�V'e— 10,S-- BUILDING LDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: jZfCOMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 2_3 NUMBER OF DEVICES (if low voltage): 1 C,.P, � QQvI({S FIRE ALARM? ❑YES ANO ASSOCIATED BUILDING PERMIT#(if applicable): ll , DESCRIPTION OF WORK: w l e ►� L C-e ILI � cim M that; CONTACT INFORMATION y� OWNER NAME: C f U Wu_yN 54uc�l d TENANT NAME(if Commercial): C V'G nYj hV OWNER MAILING ADDRESS: STREET Z I cky_eif v9vt� + U CITY G STATE ZIP OWNER PHONE: Z0(0 ZZ' ^COL 1 OWNER EMAIL: CONTRACTOR NAME: r) 'CA/1'I-- CONTRACTOR ADDRESS: STREET L(O ►�Jam__S /�� CITY I�-C/I l� STATE L_A 1 ZIP� �Z.- CONTRACTOR PHONE: ZS-3 r Los-6 CONTRACTOR EMAIL: V hl I�-}reCJ t•C CONTRACTOR LIC.#(REQUIRED): OTS 14 033 2-P ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): 3'N43 PRIMARY CONTACT: ❑ OWNER 4 -EONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: n CONTACT PHONE: Z-S-3 _YtS 1 f CONTACT EMAIL: AGREEMENT. T hereby certify that l 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 ", Vi PERMIT# Owner/Authorized&ent Signature Date (Revised 10/12/2015)