2009 RAINIER AVE 2017-06-29 - Laserfiche WebLink

ECTRICAL PERMIT AI - LIC�ATION CITY OF EVERETT PERMIT SERVICE:� 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � ww�N.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ��G• �' � BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED FR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF Uf�ITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $' �r�.� NUMBER OF DEVICES (if low volta e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: � � � ; CONTACT INFORMATION OWNER NAME: � TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReeT � /�-, CITY STATE �� ZIP �� 'yC.,�� OWNER PHONE: � , � OWNER EMAIL: CONTRACTOR NAME: ;� � CONTRACTOR ADDRESS: srReeT � I. ; (}�� `�' CITY ��` STATE �ti4 ZIP �� CONTRACTOR PHONE: ,�jQ �� CONTRACTOR EMAIL: �'� ' /� `� CONTRACTOR LIC.#(REQUIRED)�. ;�j �n� � I�i CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ��1Z� PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) C NTACT NAME: CONTACT PHONE: aJ p�I �C� � ��.,�'�'�j �� ,�� CONTACT EMAIL: � Cvl� AGREEMENT:T hereby certify thaf I have read and examined fhis application and know the same to be true and correct. All pro iisions of/aws an� rdinances governing this type of work will be completed whether specified herern or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other stafe or local law regulating construction or the performance of construction. Thaf!am authorized by the owner of this property fo perform the work for which application is made and! comply with the State Contracto�s Law 18.27 RCW and 296.200 WAC. Crty of Everetf Official Use On/y FE=E .�f � (� � FERMIT# � � � � � I1� E= I �D�- j �l � Owner/Authorized Agent Signature Date (Revised 10/12/2015)