2909 21ST ST 2017-01-13 - Laserfiche WebLink

� � ELECTRICAL PERMIT APPLICATION 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 INFORMATION PROJECT ADDRESS: � ?i � S� S'i"./L,-l�-� �i Ue✓'es�-T U� � BUILDING AREA (if residential, new construction, remodel, or addition) � p� SF BUILDING TYPE: �SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: C� 1..i �, �� l vt � ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ Zvf/a NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES [�NO AS50CIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: l G- !✓lv ' Cti✓�- d- - v�, C'_ �,+J 1 V t✓< <' . 1� r��. � uJ�✓� Lc' r l� � Q CONTACT INFORMATION OWNER NAME: �� Irp �; ,� TENANT NAME (If Commercial): OWNER MAILIlJG ADDRESS: sTReeT Z Z 1 S-F' -�'t/� ��l CITY � �%� f�'I'-�'� STATE �� ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: � v� �- � � (� CONTRACTOR ADDRESS: s-rReer � � *� CITI' ��/\/�� ✓� l S� C�✓L � STATE 1/V � ZIP �( �� p L CONTRACTOR PHONE: ��`.�' � '"'] Cy C% �1 CONTRACTOR EMAIL: � ��,��•� �- �,�,� �(, �V ��,y�i' CONTRACTOR LIC. #(REQUIRED): L N/�J� - L � �'j ��%1q(, CITY OF EVERETT BUSINESS LIC. #(REQUIRE : ',� Z,Z PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR OTHER (Please Specify) .J•:> s� C�i a.h' �p-,/ Q(� �'v (�„ CONTACT NAME: CONTACT PHONE: �� s" C� � 3 •� cj �� � c' l,1'n (� � !J u �- �Q..� CONTACT EMAIL: � L � p i,1 Q� �j �� Qi lnr" L�; 4-,.7 AGH�tMtN l: I hereby certiry that I have reatl antl exammetl this applicahon and know the same to be t�ue and correci. HII prov�s�ons ot laws antl ortlinances goveming this type of work will be completed whether specified herein or nof. The granting of a permit 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 I am authorized 6y the owner of this property to pertorm the work for which application rs made and 1 comply with the Siaie Confractors Law 18.27 RCW and 296.200 WAC. I�_�2�" �� Agent Signature '' Date City of Everett Official Use On/y FEE I � � � PERMIT # E �.C�c�—C�Z�3 (Revised l0/12/2015)