10908 10TH DR SE 2017-06-07 - 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)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 10IVA 'Dr S I VnT4 I N A 4`166'Zo Go) 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: j'� ri 4 01,—Ve t� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES JjNO ASSOCIATED BUILDING PERMIT# if applicable):rr DESCRIPTION OF WORK: 01 IM y II II I / C�O/NTACT INFORMATION OWNER NAME: V C/ �� TENANT NAME If Commercial): OWNER MAILING ADDRESS: STREET 10C10 (?) 1 V 6�1 �o SF CITY _V v eV_V 4 STATE OWNER PHONE: �2 �ZZ� c�22- /I OWNER/(EMAIL: CONTRACTOR NAME: IN CONTRACTOR ADDRESS: STREET/)�j� /J /^ 1C /� CITY Lam"�kz Ste/�{ S STATE �" � ZIP "/ CONTRACTOR PHONE: '-125 234 —0!e t3 CONTRACTOR EMAIL:rlL� (k,VI CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQUIRED): O PRIMARY CONTACT: NER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: l CONTACT EMAIL: AGREEMENT.1 hereby certify that I have read and examined this application and know the same to be true and c rr ct. All provisions olYaws and or nances 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 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only 11�111�71xl"� Z PERMIT# E Owner/ t ri ge gn ure / Date (Revised 9/23/2016)