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

'11111 —1 rLECTRICAL PERMIT A.3 LICATION CITY OF EVERETT PERMIT VICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION �Q PROJECT ADDRESS: -131104 3`` � v"[ w1�v c?J 2� 1 BUILDING AREA(if resi ential, new construction, remodel, or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED El DUPLEX El MULTI-FAMILY-#OF UNITS: El COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ L{ •�� NUMBER OF DEVICES (if low voltage): FIRE ALARM? El YES W10 ASSOCIATED BUILDING PERMIT#(if applicable): Of r_ DES .RIP ION OF WORK: nc— ` 04 G1` &_e � S '- J a _ (GFS ly,rs CONTACT INFORMATION OWNER NAME: t1 ►, -t.,3 54.4-p TENANT NAME(If Commercial): -- OWNER MAILING ADDRESS: STREET 51-to�f s, `�' CITY Ec 1 03,6- STATEW ZIP W OWNER PHONE: ( —,e'7 5-- 30`2. -tai —211 T OWNER EMAIL: JJ IJ ^� ~rfvr-, rzrn.. CONTRACTOR NAME: A1421..64---) ,/�)I\G� _) ( Y\e"r W A Skalt., ©L 1J -z)n ` Ztit CONTRACTOR ADDRESS: STREET ;,,rn,e__ - CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: p.r9Uv�. CONTRACTOR LIC.#(REQUIRED): ----- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: WNER El CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT:T hereby certify that I 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 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 FEE CAS .0 PERMIT# asc,„ tv( E -OL Owner/Authorized Agent Signature Date (Revised 10/12/2015)