10825 EVERGREEN WAY 2017-07-12 - Laserfiche WebLink

LCTRICAL PE %� T APP�.rCA® 9`. 'FoMr 1114 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: i 0 i Z3 ` Q I BUILDING AREA(if residential, new constru ion, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: 6 S, I-eS LECT ICAL A PLICATION INFORMATION CONTRACT PRICE OF W K: (, ( NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 1 ,2kw24ro e;f- +.b LtfD S%n 1:+ 'fit- �ej CONTACT INFORMATION OWNER NAME: L,ea✓: - A fe SctIeS TENANT NAME(If Commercial): L yJ4 ? I eT OWNER MAILING ADDRESS: STREET 10!7 25 tr b CP L--O CITY E V iefC T 7' STATE ZIP d OWNER PHONE: L( S "3�( �-`lZg;� OWNER EMAIL: CONTRACTOR NAME: Fner A k2 ¢ {, L CONTRACTOR ADDRESS: STREET O g �~ C �j CINm V/0dJ STATE L-L ZIP 9 �Q CONTRACTOR PHONE: -I ZS- 7SZC' ICONTRACTOR EMAIL: tf AS QCMS rw -c ✓`',- CONTRACTOR LIC.#(REQUIRED): AI R6,M 334� ICITY OF EVERETT BUSINESS LIC.#(REQUI D): p p a PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: y�6 —r44 3z '4'ie—I wzcu r CONTACT EMAIL: - AAT E-MS ,-.- - C o'" AGREEMENT:1 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# O hori ed Agen nature Date (Revised 9/23/2016)