3606 EVERETT AVE 2017-10-12 - Laserfiche WebLink

FLECTRICAL PERMIT APPLICAMN CITY OF EVERETT PERMIT -OCES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 J FAX 425-257-8857 j (E)everetteps@_everettwa.gov www.evereftwa.gov/permits PROEC-T. lTr= INO ..j OR tiog PROJECT ADDRESS: BUILDING AREA(if residential, new construction, remodel, or addition) SIF BUILDING TYPE: 11 SFR-DETACHED EISFR-ATTACHED EIDUPLEX El MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION RIMFORMATION CONTRACT PRICE OF WORK:$ i NUMBER OF DEVICES (if low voltage): FIRE ALARM? El YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: DYNE j C) r)'j V) (F j-) AfNe q-o ZS' t�i ta)A c, Lo ca-Pcl- ANIFORMATIO CONTACT OWNER NAME: 0,�y)ej, TENANT NAME(if Commercial):VN OWNER MAILING ADDRESS: STREET 0 ZO'S<- Re)Le I crry STATE�O 5k ZIP 0)91 OWNER PHONE:4 ZS Iq -tX4 4- OWNER EMAIL: CONTRACTOR NAME: P-0 -J-W)a, CONTRACTOR ADDRESS: STREET Z-- 4- crry JL STATE (fq�,O ZIP CONTRACTOR PHONE:4,75— ;Z-5 —d 0 1CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER CI CONTRACTOR X OTHER(PieaseSpedfy) CONTACT NAME: CONTACT HONE: 0 tr CONTACTP 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 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# f 7 ovVne6Autfionld Agent Signature Date (Revised 1011212015)