1427 100TH ST SW 100 2017-06-05 - Laserfiche WebLink

�ECTRICAL PERMIT AP�ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I �(' Z (��i � � S �t/ � � � � # � C% �J BUILDING AREA (if residential, new construction, remodel, or addition) � l � V SF BUILDING TYPE: ❑ SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY -# OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ��; ' �� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑ YES IJd"NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: �sr�j� � G-1 �ZG<.7/ � .(rlJ Stf�jJ _ CONTACT INFORMATION OWNER NAME: �71�i� %��!/w��L TENANT NAME (If Commercial): OWNER MAILING ADDRESS: sTReET �� Z 7 �D(� � 5r 5 CITY [i (/ C�" Y l-Ci `( STATE 6�V %� ZIP ��Z OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: f� r( 21-f LZ�G �G �_ �c:YG � /!/I/��u(L-�rt�j CONTRACTOR ADDRESS: sTREET CITY STATE ZIP CONTRACTOR PHONE: Z� � 3 � T� CONTRACTOR EMAIL: CONTRACTOR LIC. #(REGIUIRED): [! G %L"Zj-� '� �j � GU CITY OF EVERETT BUSINESS LIC. #(REQUIRED):OS Z PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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 regu/ating construction or the performance of construction. That I am authorized by fhe owner of this property to perform the work for which application is made and I comply with the Siafe Contractors Law 18.27 RCW and 296.200 WAC. �� Agent Signature Date City of Everett Official Use Only FEE ��SL��. PERMIT # E I��l-�`�� (Revised 10/12/2015)