7808 BEVERLY BLVD 2017-07-05 - Laserfiche WebLink

ir--LECTRICAL PERM IT AFPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.govvwvw.everettwa.gov/permits PROJECT SITE INFORMAT161k.. PROJECT ADDRESS: , *Og 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: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ /SQC-) NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: .G) / /S%�Cz� U "Im, i ONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET MY STATE ZIP OWNER PHONE:2�' j O OWNER EMAIL: CONTRACTOR NAME: �G/ CONTRACTOR ADDRESS: STREET _S —11 f_�r cny 4 LSTATE t1/' ZIP q �S CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.Thereby certify that/have read and examined this application and know the same to be true and correct. All provisions oflaws 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 otherstate 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 ono PERMIT# r.� 1 5 � Owner/A orized Agent ignature Date (Revised 10/1212015)