5404 S 3RD AVE 2017-01-18 - Laserfiche WebLink

_ECTRICAL PERMITLl®LIGATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov j www.everettwa.gov/permits • 'j PROJECT SITE`j �I�N,FyO�RMATI�Or INFORMATION PROJECT ADDRESS: 91,D Lk 5, 3� -, �i�%'U �"'6)lAi "UO 2.03 BUILDING AREA(if residential, new construction, remodel, or addition) '-2--?5 SF BUILDING TYPE:IASFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: Cc LIGE_ ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ I DD Ori NUMBER OF DEVICES (if low voltage): /01h FIRE ALARM? ❑YES ASSOCIATED BUILDING PERMIT# (if applicable): gg�� DESCRIPTION OF WORK: �.`T=-` wz�"`- or 0a't' (1 CONTACT INFORMATION OWNER NAME: /��b`e& &(\01-11 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 910 t-( S )j l y" - CITY j�I- r _ STATE Y ZIP q89-Q3 OWNER PHONE. l Z ) �rykOWNER EMAIL: I --+JI B= eAr,Q7,1%'\ CONTRACTOR NAME: Cj(iv✓YN2. 04- 0\k/wit- CONTRACTOR ADDRESS: STREET 5AMn2— /Z vwrv2 r CITY STATE ZIP CONTRACTOR PHONE: 5016"/W---1 .),-- C ' CONTRACTOR EMAIL: 6 L—h-- D -r p CONTRACTOR LIC.#(REQUIRED) PJA-- CITY OF EVERETT BUSINESS LIC.#(REQUIRED) l✓/k PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTA11T NAME: CONTACT PHONE: 6 3'55 Y CONTACT EMAIL: `1,,r, ` s ` ZLD@ tee(`.ctA^'\ AGREEMENT..T hereby certify that I have read and examined this application and know the same to be true alnd 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 state or local law regulating construction or the performance of construction. That I 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 to j FEE PERMIT# 011 C 12q -L E0E,b Owner/Authorized Agent Signature Date (Revised 10/12/2015)