2305 GRAND AVE 2016-10-20 - Laserfiche WebLink

#LECTRICAL PERMIT P#PLICATION 0. 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 PROS T SITE 11 1=OR6ViATi PROJECT ADDRESS: BUILDING AREA(if residential, new construction, remodel, or addition) BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATIONINFORMATIORI CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES L�'IVrO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: L f� r s rk, 7 CONTACT_INFORMATION QWNER NAME; Z 5 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET ' ve11 CITY .. STATE ZIP �Q OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: LLC— CONTRACTOR ADDRESS: STREET L rCITY STATE ZIP CONTRACTOR PHONE: ��'73 3 CONTRACTOR EMAIL: 2rj S .L CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT:Y.❑ OWNER 9-C6NTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 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/am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE DO PERMIT# E I Lo Q)-_ —/6/ Owne rued Agent re Date (Revised 10/1212015)