1131 RAINIER AVE 2017-03-06 - Laserfiche WebLink

. • 4rerr RL ECTRICAL 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 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 i 6 KiNA A)1 4 4 v, BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX MULTI-FAMILY-#OF UNITS: �� 0 COMMERCIAL USE OF BUILDING: (�� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): I FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: NI E() S 6K l T I I, ' L (A STALL-- . l LL - CONTACT INFORMATION OWNER NAME: t\�-:"� .T r )--\0,_f_.)(✓�/e- Y TENANT IliAME(If Commercial): OWNER MAILING ADDRESS: STREET CIN -/-^VI--(Z-- 1 STATEC ` ZIP Ciq-')°) OWNER PHONE: ff OWNER EMAIL: a" CONTRACTOR NAME: `D cEC(�Z I T`- CONTRACTOR ADDRESS: STREET h 0 /<I-A C-I\ C 51 //�� o //CITY (✓V CP-1-1,144M STATE /� ZIP q O �� 7 CONTRACTOR PHONE3QO 6I II 7 01/0( CONTRACTOR EMAIL: 1vJ�✓A � �I Shut?/1Tt��,�( CONTRACTOR LIC #(REQUIRED): D >_,.._.c'.32. ..J�..(. ,..- CITY OF EVERETT BUSINESS LIC.#(REQUIRED)©J ` (-4 PRIMARY CONTACT: 0 OWNERCONTRACTOR El OTHER(Please Specify) CO TACT NAME: r /� /� n CONTACT PHONE: LIJ�G�n . /� \>N I.f �_/Jj„)`Y�t CONTACT EMAIL:I F"` D �+�— C iJf� ` �iA 1 V.czit./ AGREEMENT T hereby ce ify that I have ead 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 ant comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE I PERMIT# C �� o E � � 1a12 -oo1- 0 er/Auth• ized Agent Signature Date (Revised 10/12/2015)