9640 EVERGREEN WAY 2017-07-05 - Laserfiche WebLink

..._ECTRICAL PERMIT AWLICATION 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: U � N� G' BUILDING AREA(if residential, new construN ,remodel, or add ion) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ( ] ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ `Stoa NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES ONO ASSOCIATED BUILDING PERMIT#(if applicable): pp DESCRIPTION OF WORK: C l 1 V i5 Vsy LIE- CONTACT INFORMATION OWNER NAME: u- h 0 TENANT NAME(If Commercial): /4e/e;— 761 OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: / OWNER EMAIL: CONTRACTOR NAME: Sear►. ,S GC�KL`/Z LvI r�!/rGGS J`j CONTRACTOR ADDRESS: STREET z yT3 S 4W X-C /CG� % CITY STATE N ZIP /0'2�d Vfj CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): SOUK 415,5 g71 9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):5-;L3 3 y, PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.Thereby 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 l 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 � �]4 PERMIT# E � Oq - IK 0 er/Authori ed t Signa ure Date (Revised 10/12/2015)