3112 TULALIP AVE 2016-10-21 - Laserfiche WebLink

Apr 04 16 11:41 a p.3 E�CTRlCAL PERMIT AP*lCATlON 4Z77- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1l VI-e— BUILDING AREA(if residential,new construction,remodel, or addition) —Sr BUILDING TYPE: ❑SFR-DETACHED SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-##OF UNITS: 12 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: 2 (J� NUMBER OF DEVICES if law voltage)- HIRE olts e :HIRE ALARM? ❑YES p NO ASSOCIATED BUILDING PERMIT# if applicable): 1 DESCRIPTION OF WORK: LOW VU I T Kia ✓� r (�(l��Lf CONTACT INFORMATION OWNER NAME: I` S ( jJl TENANT NAME(if Commercial): OWNER MAILING ADDRESS: CITY -L-b�-L t/ STATE ZIP OWNER PHONE: 5(7 L{ aLj� flyyNER EMAIL: CONTRACTOR NAME: "Y �5 �`r vi�> P�. �i 1� L T l�L CONTRACTOR ADDRESS: STREET 14--1 '//`2 "Z� CfrYY ✓I I L-L_ STATE CONTRACTOR PHONE: CONTRACTOR EMAIL: 0 G Y C�S�-r6 0-'k CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED)O 4,)--)4 PRIMARY CONTACT: ❑ OWNER 4CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME; 1 CONTACT PHONE: Ja STJ V\ t V J�C VJ�� l� CONTACT EMAIL: )D C1 C Y1�C C<S� v1 AGREEMENT..,T hereby certify that!have read and examined this application and know the same to be true and coned All provisions of laws and ordinances governing this type of work will be completed whether specified heroin or not The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stafo or local law ragutating construction or the performance of construchbn. That/am authorized by the owner of this property to perform the work for which apptication is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 'I 5�t o� PERMIT#t —) OwnerlAutborized Agent Signature Date (Revised 40/12/201 )