2514 GRAND AVE 2017-06-02 - Laserfiche WebLink

ELEGTR�GAL PERM ITAP PLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION r PROJECT ADDRESS: BUILDING AREA(if residential, new construction, remodel, or addition) &0 SF uk� t BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICA INFORMATIO CONTRACT PRICE OF WORK: $ U NUMBER OF DEVICES (if low voltage): ` FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): jD DESCRIPTION OF WORK: I& (> N� A 750 --066 L,? R CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (� (� CITY C..-1/ S2 Zip OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: SLj CONTRACTOR ADDRESS: STREET CITY U L� U !`-' STATE M V ZIP I O d V CONTRACTOR PHON --7SD 1CONTRACTOR EMAIL: 6Py CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#( QUIR PRIMARY CONTACT: ❑OWNER "CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: T CONTACT PHONE: �� )(`� - 7YD7 CONTACT EMAIL: "� LLi ,s AGREEMENT.'Thereby certify that/have read and examined this application and know the same to be true and correct. visions 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE �C1a � 2. PERMIT# � ? �A E 42 - SO rIAuthorized Agent Signature Date (Revised 10/12/2015)