723 GRAND AVE 2017-03-09 - Laserfiche WebLink

4rErr 1 ,_ECTR C L PER' IT APIAC, TION 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: !� 3 bra y,,d A l/-e_.., BUILDING AR (if residential,new construction,remodel,or addition) SF BUILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ /[-7i) NUMBER OF DEVICES (if low voltage); FIRE ALARM? El YES El NO ASSOCIATED BUILDING PERMIT#(if applicable): tv/,a DESCRIPTION OF WORK: ✓2,ego/a r.t� Ion A C e nit.P✓ CONTACT INFORMATION OWNER NAME: G4-0_, LCON Cu'CI TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET '7, 7 i 7 r /i i/1 c,se CITY C4---,./Or PTT STATE 11/A ZIP q c2(5/. OWNER PHONE: 4OR,5-��O , /0- OWNER EMAIL: CONTRACTOR NAME: S,Q/'-t& Ekeill. CA./,�v/,J 7PY V i'CC'S CONTRACTOR ADDRESS: STREET a 74.0 / p .6 av pc,iv Pr 4c/ S-. CITY i() /a�, d .J )- STATE lid ZIP 95 90 CONTRACTOR PHONE: 3-. 3 q-7- 900 CONTRACTOR EMAIL: >FA eA,, ® Se/../e6-c/ec -'ca/ C 6 i7-1 CONTRACTOR LIC.#(REQUIRED) 43 //J 66 / / CITYtOF EVERETT BUSINESS LIC #(REQUIRED) 05(J/q PRIMARY CONTACT: 1:1OWNER L`f CONTRACTOR ❑OTHEReci Please S ( P fY) CONTACT NAME: CONTACT PHONE: e../a j) 3 9 7 / ?Soo SfepApki Le,AJ-z, CONTACT EMAIL: ,j-4,OA r1 S�// e/Pr',tiraJ. Co h-, 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 lam 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 I PERMIT# 410Al i//e/�65/7 EnDI- � � Lo Owner/Au orized/gent Signature Date (Revised 10/12/2015)