5701 BEVERLY LN 2017-04-05 - Laserfiche WebLink

ECTRIC�L PERMIT A� LICATION 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 S�ITE INFORMATION PROJECT ADDRESS: � � i, `- � ,� (� � � �,'��- -� BUILDING AREA (if residential, new construction, remodel, or addition) _ 1 SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ GUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDWG: ��,.� 1� ,�,� c� � ELECTRICAL APPL.ICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES ❑ NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: �� t,,,1.� n.�- r�, „t„ �,J 2 ,,� i'YI • �,, "� I � c- � L, t,,,� `� � `� CONTACT' INFORMATION OWNER NAME: � TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srRee-r CITY STATE ZIP OWNER PHONE: �-P �� ^ I S � I LCJ OWNER IEMAIL: CONTRACTOR NAME: ,y� : � �1 � •r �L � ( �w CONTRACTOR ADDRESS: sTREeT "� � ' � CITY - Q v� � y� STATE ZIP CONTRACTOR PHONE: � 2� �� v � CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): 1�j,� � y- `�1 S Z � CITY OF EVERETT BUSINESS LIC. #(REQUIRED): '� I C r� PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHE=R (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACI� EMAIL: ACREEMENT: 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 type of work will be complefed whether specified herein or not. The granting of a per��it 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 I comply with fhe State Contractors Law 18.27 RCW and 296.200 WAC. OwnerlAuthorized Agent Signature � �� Date City of Everetf Official Use Only FEE �,,�� �} �' 1.�,��'�� �� PERMIT # E,��-�� (Revised 10/12/2015)