6016 W MAGNOLIA AVE 2017-06-21 - Laserfiche WebLink

�ECTRICAL PERMIT AF=LICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: BUILDING AREA(if residential new construction, remodel, or addition) SF BUILDING TYPE: I&SFR ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL ❑ INDUSTRIAL USE OF BUILDING: ELECTRICA AICA/ 1 N INFORMATION CONTRACT PRICE OF WORK: C G NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: �(� rc� S�G TENANT NAME (If Commercial): OWNER MAILING ADDRESS: STREET crrY ��.a-tom_ (� STATE \,,,•j.A ZIP d c,:3 OWNER PHONE: lZ r Z rc S OWNER EMAIL. CONTRACTOR NAME: I V, -e- Z_ CONTRACTOR ADDRESS: STREET 4 0;�5 L:, vH� . My <� w .v.. l� STAT- �jA ZIP CONTRACTOR PHONE -o. S L c I CONTRACTOR EMAIL: CONTRACTOR LICENSE#(REQUIRED): k: — L CITY OF EVERETT BUSINESS LICENSE (REQUIRED): 3tiy PRIMARY CONTACT: DOWNER ❑ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: tt L . 2 itj7 4 CONTACT EMAIL: AGREEUIENT:T hereby certry that 1 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 1 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 PERMIT## o S - U5 Owner/Authorized Agent Si nature Date (Revised 09/25/2015)