3515 FRIDAY AVE 2017-05-23 - 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 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I C ,J; f ! t l� '. t \i'w_./`e (, u'4- BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: IFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL'APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 7 -' NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES Q-60— ASSOCIAT :D BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: i `C /1-g cam' " CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITrI/L� �r2 f7 srr.TE - zip L i t' OWNER PHONE: - - (j / OWNER EMAIL: CONTRACTOR NAME: Ji 71171f CONTRACTOR ADDRESS: STREET CITY t '` -6� STATE CONTRACTOR PHONE: . ( i CONTRACTOR EMAIL: r,�CZ4h0 CONTRACTOR LIC.#(REQUIRED): " ?GL t/ t' � CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 8105THER(Please Specify) CONTACT NAME: b CONTACT PHONE: - 3 7 j CONTACT EMAIL: AGREEMElNT,t hereby certify the t 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 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# 'Z Owner/Authorized Agent Signature Date (Revised 9/23/2016)