233 DORN AVE B 2017-04-10 - Laserfiche WebLink

�iI CTRICAL PERMIT API 11iCATI®N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: z3 17erh V vv- Z BUILDING AREA(if residential, new construction, remodel, or addition) s,00 SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX R MULTI-FAMILY-#OF UNITS: L� ? ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ / NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ANO ASSOCIATED BUILDING PERMIT#(if applicable): // // DESCRIPTION OF WORK: le 42 �Ae' � `lett, �fS � % S k7"A�'rl 0110' d- z 4 /-f CONTACT INFORMATION OWNER NAME: 11111 i'ALS( IA/ov 2 n TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Z �7 liOl/? ✓� vY1 V z CITY �� STATE OWNER PHONE:��0 7Z O/CJ OWNER EMAIL: CONTRACTOR NAME: 490 -;-If G CONTRACTOR ADDRESS: STREET FO �Z 7 CITY Z Vqpf yvOO 1 STATE U / ZIP Te Q CONTRACTOR PHONE:?-06N� 3 CONTRACTOR EMAIL: -!rle e�,e ✓C �Aa /ow,r /ev r4if CONTRACTOR LIC.#(REQUIRED): �Lo i mOs f� CITY OF EVERETT BUSINESS LIC.#(REQUIRED):D`IaTG PRIMARY CONTACT: ❑OWNER P15ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Z d 5'2r 4/1 y CONTACT EMAIL: a'u-C AGREEMENT.,Thereby certify that I ave 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/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 FE� PERMIT# E Owner/Authorized Agent Sigatu Date (Revised 10/12/2015)