2709 CALIFORNIA ST 2017-01-13 - Laserfiche WebLink

��w� �� i.ECTRICAL PERMIi 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 CONTACT INFORMATION OWNER NAME: �'/Z/2' �'G�Lff1C TENANT NAME (If Commercial): OWNER MAILING ADDRESS: srneEr � ` �� -%jl-�� CITY ��"�� STATE -�� ZIP OWNER PHONE: � ,�.0 � �S�C �� OWNER EMAIL: �Q6/'' - �iZll./�ZGlC l, G C� / ' ��'/// CONTRACTOR NAME: CONTRACTOR ADDRESS: sTREET CITY .��J�� STATE ZIP CONTRACTOR PHONE: ��1�� C�%��ZG � CONTRA 'OR EMAIL: CONTRACTOR LIC. #(REQUIRED): � G� 2�i�' � CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT: T hereby certify that 1 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 completed whefher specified herein or not. The granting of a permit does nohpresume to give authority to violate or cancel the provisions of any other sfate 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 1 comply wifh the State Contracfors Law 18.27 RCW and 296.200 WAC. . � ` ��ti�� / .�� Owner/Authorized Agent Signature City of Everett Official Use Only FEE � I�D, G�_'- PERMIT # E � (.�� I I � (Revised 10/12/2015)