1600 121ST ST SE 2017-06-07 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION Eta 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: 1 J h00 (2-1j- E Jr�rieet vhi6<06 ' BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ElSFR-DETACHED *SFR-ATTACHED ❑ DUPLEX MULTI-FAMILY-#OF UNITS: ElCOMMERCIAL USE OF BUILDING: r irvn L C,T( d evi c-e. Cof dO&7 in /'t4 M ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ O O S !/YjGi G NUMBER OF DEVICES (if low voltage): FIRE ALARM? 1A YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: e 10C.If-11 WaWC.0f e---r 67nd , Croaramma6 e, I ermo ta onMai-,o Rc;ur Leve 2 Z a I/a6l�' 26 r" ecu/' s L Irl-e L,7e / erm o.rtq l h o -8 .S .3 G rs 14qS 52 /' CONTACT INFORMATION OWNER NAME: C/'o G f //( / ( TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET 1600 I J S/c. V(7( F l b f 0 C �} CITY LI v�` STATE V ZIP 90208 OWNER PHONE:42-S' 646ra OWNER EMAIL:ry4v.gobtfc h It ch rontt'ey' C O/n CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(R QUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER 1:1CONTRACTOR 11OTHER(Please Specify) C NTACT NAME: CONTACT PHONE: L- 2 J ¢ 1-9 61-G,,6 Udc o��s CONTACT EMAIL: U t Pt&JCA�� LY* Com AGREEME T.I hereby certify that I have read and examined this application and know the same to be true'anb4orrect. 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/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 PERMIT# IZ7 lzot7 E Owner/Aut46rized Ag&t Signature Dae (Revised 9/23/2016)