2502 HIGHLAND AVE 2017-07-27 - Laserfiche WebLink

-EC TRICAL PERMIT AF .- -OCQTOON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION' PROJECT ADDRESS:`Z [ BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑mum-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ QCT % NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ONO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �a " /`DU v 4 r P /,j CLQ rr �✓D`r` S° C s2. CONTACT INFORMATION OWNER NAME: '��t [uh TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET Z 5 02— MY 2— MY STATE G- � ZIP OWNER PHONE: L(2 2 )rq OWNER EMAIL: CONTRACTOR NAME: �i•� d ��'c� CONTRACTOR ADDRESS: STREET v c A /- 1 crry G. ` h AO-— STATE[�v zip ',�-21Z CONTRACTOR PHONE: b D 7y6 CONTRACTOR EMAIL: CONTRACTOR LIC,#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: /' / CONTACT PHONE: �C /�L l��j{iOt! CONTACT EMAIL: `p P AGREEMENT.T h reby certify that 1 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 specked 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 l am authorized by the owner of this properly 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 FEE l/ PERMIT# O nermuthorized Agen lgnature Vate (Revised 10/12/2015)