1801 63RD ST SE 2017-03-10 - Laserfiche WebLink

02,x'0312017 10 : 28 #1686 P. 001/001 elj-A--- LECTRICAL PERMIT AIO1.,ICATIoN CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425.257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits .. PROJECT SITE INFORMATION pROJECTgODRESS: CJ 6 � S ..f "— BUILDING AREA Of residential,new construction,remodel,or addition) SF BUILDING TYPE:.F.rSFR-DFTACHED ❑SFR-ATTACHED 0 DUPLEX El MULTI-FAMILY-#OF UNITS:_ 0 COMMERCIAL USE OF BUILDING: ,r '- " eJ.ECTRI AL.APPLICATION INFORMATION CONTRACT PRICE OF W �.UOU NUMBER OF DEVICES,if Iow voltage): r FIRE ALARM? El YES, 0 NO ASSOCIATED BUILDING PERM ' if a..licable : DESCRIPTION OF WORK: I,�'/4 • I V. i p4A1(.L CONTACT INFORMATION OWNER NAME; t A Ai f :illI.. ix , , .i_.; • NAME(If Commercial): OWNER MAILING ADDRESS: sTREE r 7/CCi tri /,�C,dsT , 1_ _V A CCTV / / '. '�/ sTA 1 ZIP OWNER PHONE: 'mss 7?0 2.23 7 OWNER EMAIL: CONTRACTOR NAME: i / A. lad I CONTRACTOR ADDRESS: sTREEr '.•C, i _ _ ' / ` iJ,//�l CRV ? _,./ STATE Lam/ ' /CJ i=sZ V CONTRACTOR PHONE: 1) )J 1 i 1(/ CONTRACTOR EMAIL: -!------Th ) CONTRACTOR LIC.iI(RJ;L2UlRFD): L- � *E% o4/v.rs/�2 ICrry OF EVERETT BUSINESS LIC.#{REgUIRE p)�4--? PRIMARY CONTACT: Ca OWNER atONTRACTOR CI OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: '2I .7 ,/ 'z3, J l T(� ee/1/WV L '� CONTACT EMAIL: I'' AGREEMENT:I hereby oar*t at l have reed herein t� d, and bow the same M be true and mama All o1 work will be completed whether provisions o11ah and ordinancesOf govern e s type locoi law regulating�r or the h permit does not the ownersume f tva e r pe y to perform or cental fur which ars of any other stets or performance RCW of m9sxruet#W. That 1 am authorized by the aw►er of this property perl4ym the wrxlc for which 7s merle and 1 comply with the State Contractors Law 18.27 RCWand 2t?8200 WAG /6�0 U6 16 City of Everett Official Use Only / 1T ? O ]/,� ' . /OwnrIAuth• .�. A : r Data. (Revised 5/231201(3)