5301 COLBY AVE 2016-05-19 - Laserfiche WebLink

• • #1/111•1 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 I - Li / (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov 1 www.everettwa.gov/permits PROJECT SITE INFORMATIONG PROJECT ADDRESS: 5,-.2)0 \ Cc �� ( 1 t Jc . u1m t 105 C IICJ4. =�t V\I� 7. BUILDING AREA(if residential,new construction,remodel,or addition)_ SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX X MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ') CIO. (1(3 NUMBER OF DEVICES (if low voltage): I FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �1<�lC, 1�Zt( -V I 17-.e ('(\ 'ler_t x1`j\‘tlf1 C1��c,t fj c c lY;(_ rvr' (\o •e� 3 0 n1LL4 - J CONTACT INFORMATION OWNER NAME: \\) \j \( j Qt._) I l(t TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STRET J 11O\ Cp\\,:)v3 �J'11 T' I l 5 (� CITY f-e-sre_ J SIA C �J/� ZIP -1 � OWNER PHONE: l-\,),r> )•\U .i Z�j JI OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: srRCLT 3.7S1 f:_) j Lr'' city �(' .-}—ike- srATF\, ZIP (l`2,\,�`-j CONTRACTOR PHONE: 2c* c'&2)- 9433,a CONTRACTOR EMAIL: `),;-Q "k .�) , f\\ ) C ,S\'1 C\r„,-' C.1 ' CONTRACTOR LIC.#(REQUIRED): P j W '1 I t'-,\ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ?1•10.7—. PRIMARY CONTACT: ❑OWNER Al.CONTRACTOR 0 OTHER(Please Specify) CONTACT� NAME: CONTACT PHONE: a,„„ , l fl 7 d j Li C t �l 2.V\��. CONTACT EMAIL: I�lPrl TEa �v e fe:-f+'t(• AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this typo of work will be completed whether specified herein or not. The granting of a permit does not presume to give aurhonty to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That I am aulhonzed by the owner of this properly 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 I^ )rO9 PERMIT ;1111 / I IL° E UQQ\ OCY'l Owner/Authorized Agent Signature Delo (Revised 10/12/2015)