10809 9TH DR SE 2017-06-07 - Laserfiche WebLink

ELECTRICAL PERMIT At4ILICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.gov/permits d PROJECT SITE INFORMAT10N` PROJECT ADDRESS: 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: a , ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage):: K� FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): ! DESCRIPTION-OF WORK: 1-e ^,x L4-P CONTACT INFORMATION OWNER NAME: U I ;C ;h , 6'-- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET V' CRY ` STATE ° .1 OWNER PHONE: 3 3 y OWNER EMAIL: CONTRACTOR NAME: C_ ` VA ` C�— =I ¢`'L, 4 e!v','t C, 1, CONTRACTOR ADDRESS: STREET ? o JX Z 5 CIN t^/ STATE 1 tB /�� ZIP CONTRACTOR PHONE: ZC>L L/Z Z �C S7 CONTRACTOR tAl GO �' "L �e� C�'✓` CONTRACTOR LIC.#(REQUIRED): C ��C" .S g`i r�� OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 1 1 V V \o" CONTACT EMAIL: AGREEMENT:Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws am ordinances governing this We 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 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# E I-211 l Owner/Autho ed Agen ignafu're Date (Revised 90/1212095)