1115 RAINIER AVE 2017-06-27 - Laserfiche WebLink

4Err ELECTRICAL PERMIT APPLICATION 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 vvww.everettwa.gov/permits PROJECT SITE JNFORMATION PROJECT ADDRESS: // J .6-- 'i tk\ 0 1:- iL - Nt r-- 7- BUILDING AREA(if residential, new construction, remodel, or addition) SF . ,.., BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX Nkk<ULTI-FAMILY-#OF UNITS:1) 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): . I FIRE ALARM? 0 YES XNO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: 1 Ng-CAL-LAT bet) DI- Sc-e- uz I T / fivor(— CONTACT INFORMATION OWNER NAME: Fa-V IT:a,)-..--ITI- 1---It(I A)a, jr-r.)1)ENANTpAME(If Commercial): OWNER MAILING ADDRESS: STREETS i 0 C 0 1----b4 1A:\1 ill crr( ry i_E_ ./:---r1- STATE I„)14- ZIP OWNER PHONE: OWNER EMAIL: •*- * - • - - 'z.-- - - - - ,.._.- ' "- ,...._,—--- ' " ' ' ' • ' • - - - ' -- ' - • ' CONTRACTOR NAME: ( A...,<N,,F2-)„A„,0 CONTRACTOR ADDRESS: STREET i r k E.t/U 1 J(--K 1 5 ciTy 6;-_ Li voc,tAJ-t, STATE II\).4- ZIP CONTRACTOR PHONE: SW C't---17 c/ ID CONTRACTOR EMAIL:IA\KETrAit).-4..._. 6-0,6/2- 14/1.)5LAirk'Ci, , i r 1_3 CONTRACTOR LIC.#(REQUIRED):Gagb a-3S K CITY OF EVERETT BUSINESS LIC.#(REQUIRECC)33 tA'- . _ PRIMARY CONTACT: 0 OWNERj:SrfRACTOR 0 OTHER(Please Specify) CONTACT N E: 7 ,\it, CONTACT PHONE: -.))/00 /11/40 i D , . ---lal M 12-DAWA12._ CONTACT EMAIL: Ay,A,-E-7Avo ikix...,c_i AGREEMENT:Thereby certify tha 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 P . , . %ilk lir V41111.111.0 6 Di-2-z. )926 PERMIT# Own y/ uthorize Agent Signature Date (Revised 10/12/2015)