1902 W MUKILTEO BLVD 2017-06-22 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 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: l ) PIUKILTIE& ''t [, N 7> BUILDING AREA(if residential, new construction, remodel, or addition) �!/ SF BUILDING TYPE: fS SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL A USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: 9��,OV25 4A,1,0 G6 Ci(/ 15T rLOOK e.4,57T .5MA" &JAw C i2.C_v 21IC- A G0w&rr t tin titU CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET1 �M7�r\ .��ri� �� CITY �I•l p tf LT STATE ZIP OWNER PHONE: OWNER EMAIL: �,'{yL"� ti� c't , CONTRACTOR NAME: ( CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME:'} CONTACT PHONE: 1 1� IJ lvt' CONTACT EMAIL: AGREEMENT/hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of law d 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# Owner/Authorized Agent Signature Date (Revised 9/23/2016)