5020 DOGWOOD DR 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION /� PROJECT ADDRESS: 5ozo DD m c d DV �v�i� C2 Q V BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED`ZE2FR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ o NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: t Z� 0 al � C tq A V,4e, CONTACT INFORMATION OWNER NAME: (/C- V 1� TE1NANTNAME If Commercial : OWNER MAILING ADDRESS: STREET Eju� c/ Dod Y- ^CITY/ �l G 12l ' STATE �/ 1 ZIP OWNER PHONE: 2� �W I — cx `✓ -f /OWNER EMAIL: (r�/ CONTRACTOR NAME: S� rl Cft I klwl(/eJ t r�/I l Cj• CONTRACTOR ADDRESS: STREET l�30 H_+_fl^nbv- sF /fir CITY � �tl./ �/'eV�/l STATE �(' ZIP CONTRACTOR PHONE: (4iZF)�2 � I�IS� (r� CONTRACTOR EMAIL: I✓ VJIDIA�-C-6A (r I�YI CONTRACTOR LIC.#(REQUIRED): I Nt�O I/��S t"J�Q�j CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O"f q l PRIMARY CONTACT: ❑OWNER >0ZONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: (L-f`2�)71�10 —3 2-03 KO(" CONTACT EMAIL: �� s C� ` n// �q . C' Y AGREEMENT.-/hereby certify that I have read and examined this application and know the same to be true a correct. All provisions of la nd 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# 2-12-7117 E > Ownerl uthoriz d Agent S' nat a U V Date (Revised 9/23/2016)