7200 HARDESON RD 2017-05-24 - Laserfiche WebLink

ANECTRICAL PERMIT APS CATION of-677 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: -7 p R BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: I NQV\ �( 7 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: 00 CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: W1 j ec`-W I NL CONTRACTOR ADDRESS: STREET o Q o CITY V"A- STATE CONTRACTOR PHONE: 'y U, 6 S 8. 0S 0 1. CONTRACTOR EMAIL: e" M I.tc,• c o CONTRACTOR LIC.#(REQUIRED)+*A6-L 0 —Ili CITY OF EVERETT BUSINESS LIC.#(REQUIRED):4)3`l 11 PRIMARY CONTACT: ❑ OWNER P CONTRACTOR ❑ OTHER(Please Specify)__ CONTACT NAME: CONTACT PHONE: Lf le..-LS Z Gj BZ 'rRQ'{ SSS CONTACT EMAIL: }.p Q ICA) 4C4,e It e_ • C o wt AGREEMENT:T hereby certify that 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 stale or local law regulating construction or the performance of construclion That t am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 16.27 RCW and 296.200 WAC City or Everett Official Use Only FEE {n PER IT# Oyt erlAuthorized Agent Signature Date (Revised 10/12/2015)