8912 EMERSON PL 2017-06-12 - Laserfiche WebLink

ELECTRICAL TICAL PERMIT AF V JCATI00N 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 BUILDING TYPE: ❑SFR-DETACHED ❑SFR -ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES MNO ASSOCIATED BUILDING PERMIT#(if applicable): ;1.)0 3i DESCRIPTION OF WORK: LIAR.- Z c_. Ao6 ..CO_.NTACT INFORMATION . OWNER NAME: esU4ds f;J TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET [��`(/Z ,/� /��2/jSuti1 /'L n �J CrTY L()GLl/r ` j,4 STATE 6j, ZIP OWNER PHONE: �{LS=3 Z7— S^�c'32 OWNER EMAIL: CONTRACTOR NAME: A)672:1-1t 2ZtX?_ RE EC f zZ6, CONTRACTOR ADDRESS: STREET /Z'q0`f BS _ qOZ JC' '' �p�� CITY Cu vl GT� !!STATE � il/F ZIP $ dYZ C ) W CONTRACTOR PHONE: 7Z7—J-""7 z-7 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): �Jp/Z%L c�(O.2iTS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 327—s(o� oo : cor�JWAv CONTACT EMAIL: AGREEMENT..Thereby cerfiflthat I have read and examined this application and know the same to be true and correct. 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 I am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/Authorized Agent S gnature Date (Revised 10/1212095)