202 MADISON ST 2017-01-13 - Laserfiche WebLink

6�ECTRICAL PERMIT AP�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 INFORMATION PROJECT ADDRESS: 202 Madison St Everett WA 98202 BUILDING AREA (if residential, new construction, remodel, or addition) Residential SF BUILDING TYPE: ❑ SFR-DETACHED � SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: Residential ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ TBD (I'm doing some of the work myseif) NUMBER OF DEVICES if low volta e: FIRE ALARM? ❑ YES � NO ASSOCIATED BUILDING PERMIT #(if a licable : N/A DESCRIPTION OF WORK: I am runnin a sub anel to m back ard for outdoor outlets. CONTACT INFORMATION OWNER NAME: Christopher & Malissa Tack TENANT NAME (If Commercial): N/A OWNER MAILING ADDRESS: sTReEr 202 Madison St cirv Everett STATE WA zia 98203 OWNER PHONE: (989) 326-1488 OWNER EMAIL: chris_tack@mac.com CONTRACTOR NAME: CONTRACTOR ADDRESS: srREEr CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC. #(REQUIRED): CITY OF EVERETT BUSINESS LIC. #(REQUIRED): PRIMARY CONTACT: � OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: (9$g) 326-1488 Chris Tack CONTACT EMAIL: chris tack@mac.com AGREEMENT: T hereby certify that ! have read and examined this applrcation and know the same to be true and correct. All 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 to violate or cancel the provisions of any other staie or local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which applrcation is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. Agent Signature City of Everetf Official Use Only FEE �� PERMIT # E; ��-� �?� �� (Revised 10/12/20i5)