8016 W GLEN DR 2017-05-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFO_ R_ MATION' ftp I I 'I . ..- ,. PROJECT ADDRESS: �(J l ' �rLie I ( `tl I/V � 'n) BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED SFR-ATTACH,rED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: 4L ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION.OF WORK: GC 12� okl�'1 I�1� CONTACT INFORMATION OWNER NAME: a��1 M SAY 1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �bv l�l r C� CRY e n`�'1 STATE ( � ZIP -I V�O OWNER PHONE: , rZ��3�"L} ��ZQ OWNER EMAIL: (v�� CONTRACTOR NAME: 11� , i V v`S `� C vY C 6l )��✓l V l V�G CONTRACTOR ADDRESS: STREI � 530 14��f�j �2 SE //� c::51 CITY v 1. L �{�`�v/� STATE V 11 U CONTRACTOR PHONE: 42G2) _ I CO/N�TRACTOR EMAIL: �C7 II�Se�eC-4G CONTRACTOR LIC.#(REQ RED): rI Q CITY OF EVERETT BUSINESS LIC.#(REQUIRED): I l9 PRIMARY CONTACT: OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: , / CONTACT PHONE: �L�� I Q C) — '3'Z O CONTACT EMAIL: AGREEMENT..Thereby certify that I have read and examined this application and know the same to be true and c ct. All provisions o ws and ori antes 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# Al /2//5-/41 E Owner/A horized 416Si ure Date (Revised 10/12/2015)