2111 15TH ST 2017-06-07 - Laserfiche WebLink

ELECTRICAL PERMIT r-a-flLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: BUILDING AREA(if residential, new construction, remodel, or addition) SF n BUILDING TYPE: SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ,L , NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: � 5L w �q L& T L) I40 CONTACT INFORMATION OWNER NAME: S�vl S -w �-�-�� O t_,� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET E-L)Z,1)' CITY STATE �J ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: L i2 L c Z CONTRACTOR ADDRESS: STREET CITY �—`J JL/Li STATE �(� ZIP CONTRACTOR PHONE: 4"/Z S- 7`71_ 7GS CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): ICITY OF EVERETT BUSINESS LIC.#(REQ ED): O 0 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t-) 2- f 7-)- —7"7c1-01, )�l fi��J— CONTACT EMAIL: 14 -1--j)7 � � c e AGREEMENT.-Thereby certify that/have read and examined this application and know the same to be true and correct. All provisions of/aws 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE o PERMIT# O nerlAuthorized Agent Signature Date (Revised 10/1212015)