1932 BAKER AVE 2017-04-10 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: �'} e>a- — BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: FR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: LECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ d NUMBER OF DEVICES if low volts FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: l� 1' :5;-FCt-+ C_ ,n cj i` C Vl Y}C C f- Y"VV4et CONTACT INFORMATION OWNER NAME: �b b-C-✓- (C� 1 (I YI ��IAtt y NAME If Commercial): G t>L 4 OWNER MAILING ADDRESS: STREET / )y1 4-e 61 Y1 '1`� "-.�t 100 ( rte► LG ,CITY V1GSTATE ' ZIP s/ 70r / et OWNER PHONE: 141 _>'7 X50 OWNER EMAIL: CONTRACTOR NAME: (� y- C�- CONTRACTOR ADDRESS: STREET C-7 ;39l`" r &V--� h J 4/�_ ��('+ -Al-), (( CITY �' p y t STATEbi. + 2,, , CT - l CONTRACTOR PHONE:"1'o- `-t0 4 CrjO��NTRACTOR EMAIL: Ino r Cif ,lYo 1Gc , nit , CONTRACTOR LIG.#(REQUIRED):y')0�,)h Ct, S-�`"C Zt_� CITY OF EVERETT BUSINESS LIC.#(REQUIRED)Q4 X--7 Li PRIMARY CONTACT: ❑OWNER NOBONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: { 6� L� CONTACT EMAIL: 6) { t t h 0 \jw_Q's cV& AGREEMENT.-1 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 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 PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016)