4840 COLBY AVE 2017-07-12 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98 201 (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits �1 C PROJECT SITE INFORMATION PROJECT ADDRESS: 4w Vvpre4t VVA Oq)L-V ) BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHEDSFR-ATTACHED ❑ DUPLEX 1:1 MULTI-FAMILY-#OF UNITS: [ICOMMERCIAL USE OF BUILDING: Cf f V1 VI Vl ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1Q , U Q0 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES 4NO ASSOCIATED BUILDING PERMIT# if applicable): Gr DESCRIPTION OF WORK: Powt OIi r2-o ce-( moS+ of fmQ hwf- ex A ej duld-eW NOW 106H- A patlt6i al l 0 1 LO OO Sal ft ticymc. ,^CONTACT INFORMATION OWNERNAME: TENANT NAME(If Commercial): OWNER oGmm ercial): OWNER MAILING ADDRESS: STREET /^ "/440 C'0110ENVe CITY EVO V(?14T STATE w 111 ZIP OWNERPHONE: (`"2�)�rD. U ; v OWNER EMAIL: &(/A CONTRACTOR NAME:/rl - w L F (f-0-VC CONTRACTOR ADDRESS: STREET /'✓;13OI :7fl V /C CITY /�` f J_/" /S STATE Wq ZIP CONTRACTOR PHONE: (q2)223I—QUI3 )� CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): IN140blESq 672 Q CITY OF EVERETT BUSINESS LIC.#(REQUIRED): DL-1 LlI[pl?) PRIMARY CONTACT: 4OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT.I hereby certify that/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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PI=RMIT# 5 �o/oma E= V] �- 0:7p4Authohzed Age ignat e7—Date (Revised 9/23/2016)