1925 WALNUT ST 2016-11-07 - Laserfiche WebLink

� � � � ELEC1'RICAL PERMIi APPL.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 INFARMATION PROJECT ADDRESS: �, � � ` BUILDING AREA (if residential, new construction, remodel, or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: � ? C� , ELE TION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: �'1S�(� � j��t V' � 1/l E ,Z � - CONTACT INFORMATION OWNER NAME: �Q,, '(k, TENANT NAME (d�Ser�ere�►F�> �� OWNER MAILING ADDRESS: srReer > n �n , , r `�,�Y �,�j�• . � �� CITY �! �G STATE ZIP OWNER PHONE: �' 7 � G� OWNER EMAIL: C�� C' -�t-'G' L CC �� C G�V�l CONTRACTOR NAME: � ' CONTRACTOR ADDRESS: sTREET CITY STATE LIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIR D): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: � CONTACT EMAIL: AGREEMENT T hereby certrfy that I have read and examined this application and know the same to be frue and correct. AI! 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 fo violafe 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 rs made and I comply with the State Confracfors Law 18.27 RCW and 296.200 WAC. --,__ c� � z z /.�� , er/Authori�eb Agent Signature Date City of Everett Official Use Only FEE �� PERMIT # E �C�o� - LC�� (Revised 10/i2/2015)