3716 COLBY AVE 2017-01-13 - Laserfiche WebLink

(P) 425-257-8810 .ECTRICAL PERMIT AF LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE tNFORMATION PROJECT ADDRESS: •��I I I.P W � rJy � v C/ 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: � ��YVLQ, ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ Z� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES � NO ASSOCIATED BUILDING PERMIT # if ap licable : DESCRIPTION OF WORK: - � (�Y � I� NER NAME: �GIVY� !'CK�V � NER MAILING ADDRESS: srReET GTY [/�/`(�/Y NER PHONE: � LvIX 1�1'�✓ �^ 71� � CONTACT INFORMATION TENANT NAME (If Commercial): OWNER EMAIL: N � � NTRACTOR NAME: �h��/ �j`-�',F/��{�I,G�LI S�VI l�iS NTRACTOR ADDRESS: srReer I��O � I�"�� Dr � TRACTOR PHONE: R LIC. CITY � � �j 25 ) Z3°I � a� � � �ED): IIVH�uES(v5Z STATE V V r ' ZIP � �li�/ / �s STATE �� ZIP � V�[/ CONTRACTOR EMAIL• C� � l fi V l�� •��% � CITY OF EVERETT BUSINESS LIC. #(REQUIRED): ��I4 PRIMARY CONTACT: ❑ OWNER ONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: L�-ZG� ��O ��'L(�I�j �jl `�(j� CONTACT EMAIL: I j"P�Q/✓.e S G� iYI G1,1 •�m AGREEMENT: T hereby certify that 1 have read and examined this application and know the same to be true n correct. All pr isions o ws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to ve authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property 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 � �� PERMIT # EWll�O�' � I (Revised 10/12/2015)