802 E MUKILTEO BLVD 2017-06-22 - Laserfiche WebLink

,_ECTRICAL PERMIT A. : ILICATION 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 t `1 PROJECT ADDRESS: a 'J 1Cl 1'f e® U ( A3,2-0 BUILDING AREA(if residential, new construction,remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: OMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ Z NUMBER OF DEVICES if lov►.voltage): FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: v— Zf— UL 1CI� CONTACT INFORMATION n OWNER NAME: j4- -{ TENANT NAME If Commercial :Rce i fa`ic NA+ (' OWNER MAILING ADDRESS: STREET lJ K My STATE ZtPX 7A �} OWNER PHONE: q Z - 7,5-7 OWNER EMAIL: , /�+ CONTRACTOR NAME: IIIA C 01�0� U I If CONTRACTOR ADDRESS: STREET I/ - CRY i STATE r ZIP CONTRACTOR PHONE: l CONTRACTOR EMAIL: -zO f rT CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIG.#(REQUIRED) PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) q CONTACT NAum• CONTACT PHONE: Z45 3 — lj�) f" l ,TO U)11 7&n CONTACT EMAIL: O � �'� �7E .(D rl�-) AGREEMENT.,T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of taws and ordinances governing this type of work wilt 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 t comply with the State Contractors taw 18.27 RCW and 296.200 WAC. City of Everett Oficial Use Only FEE T# PERMIT a6 oar � J� E k!�oC) Z-1 Owner/Authorized Agent Signature Date (Revised 1011212015)