1228 58TH PL SW 2017-03-10 - Laserfiche WebLink

4En- .ECTRICAL PERMIT Al LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: �o,9 cy— `�� Ty - s( ____, • BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: a,SFR-DETACHED El SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 6-. 0- .'.- NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES (2.NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: ih C i(' 4,/ I I �-)CONTACT INFORMATION OWNER NAME: )et I./� /7 CGl7 TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET s(,(/!/b' `O CITY STATE ZIP `' ' ✓ 1175 OWNER PHONE: (=" ' 71 eL OWNER EMAIL: CONTRACTOR NAME: r(P7/ "L ' / l� CONTRACTOR ADDRESS: STREET / 5 /?.,?, N s / ' �p�--` CITY ��tTvlr STATE (.../.-//49 "- ZIP 76 O CONTRACTOR PHONE: -' °b 7/�`?v./2e CONTRACTOR EMAIL: (11C2.)-- G / ©W 4 /(1W.-- CONTRACTOR LIC.#(REQUIRED): //QV'LD E .f f 7 3 ,efA CITY OF EVERETT BUSINESS LIC. #(REQUIRED)6 �7 6 PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: 2,0 t<' ..__ 7i 1 7 �� 9' v4u�� ci U CONTACT EMAIL: AGREEMENT: T hereby certify that h ve 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 wheth r 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 760,-° 4-7 , , , ,,,.. PERMIT# E /6000a - 001 Owner/Authorized Agent Signatu D to (Revised 10/12/2015)