216 HEATHER RD 2017-05-24 - 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)everatteps@everettwa.gov I www.everettwa.govipermits 7_ PROJECT SITE INFORMATION PROJECT ADDRESS: _L1IL0 !z l) BUILDING AREA(if residential,new construction,remodel,or addition) /00 SIF BUILDING TYPE: 0 SFR-DETACHED 11 SFR-ATTACHED El DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK. $ 'Z-H 0(3 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0� 0 ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: 'Zoo Ar"in CONTACT INFORMATION OWNER NAME: TENANT NAME(if Commercial): OWNER MAILING ADDRESS, SrRM 7_ r clTv (:31 STATE ZIP OWNER PHONE: 1OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: s CITY STATE CONTRACTOR PHONE:4`7_ CONTRACTOR EMAIL: tL)ic-Tr EF�ec' `C CC3 CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0OWNER OCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t�/ CONTACT EMAIL: 64" Z" &j4-a"l- j 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 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 too MR, PERMIT OyrfierfAutirorized gent Signature Date (Revised 10J12/2015)