6521 EVERGREEN WAY 2017-05-23 - Laserfiche WebLink

I ECTRICAL PERMIT AP .ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-2578810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 6-Z-1 �//� �Gl BUILDING AREA(if residential, new construction, odel,or addition) 44 SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: OMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ /D (- NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: 7 CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY 4� W � STATE ZIP (�L OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: G CONTRACTOR ADDRESS: STREET L �C CITY STATE ZIP CONTRACTOR PHONE: Z-' S�9_3_�_VI c NTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER [�'_CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 5 ✓� �j � CONTACT EMAIL: ) S AGREEMENT T hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of la s and nances 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 FEE PERMIT# O e 4Aut6rized AjontSignature Date (Revised 10/12/2015) 112-