4003 NASSAU PL 2017-07-28 - Laserfiche WebLink

Mar 13 16 04:11 p Vickie 3606914838 p.2 4Z77- ELECTRICAL PERMIT APPLICATION 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: Lj '1 'tel LC. BUILDING AREA(if residenlial, new construction, remodel, or addition :IvS SF BUILDING TYPE: EISFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#01F UNITS: USE OF BUILDING: ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK_$ V5&4Z�- NUMBER OF DEVICES (if low voltage). FIREALARM? ❑ YES ❑NO ASSOCIATED BUILDING PERMIT#(if ap licable): DESCRIPTION OF WORK: CONTACT INFORMATION )WNER NAME: TENANT NAME(If Commercial): )WNER MAILING ADDRESS: STREET 1 F1 crry -� r;l OWNER PHONE: t L STATE ' _ v C14-f OWNER EMAIL: ZP ONTRACTOR NAME: ( J ONTRACTOR ADDRESS: STREET ,(D r �NTRACTOR PHONE �7 ( �c srnrE Z JP �j O � CONTRACTOR EMAIL: ]NTRACTOR LIC"#(REQUIRED): ( CL�� CC�f �cl I IQ CITY OF EVERETT BUSINESS LIC"#(REQUIRED): , ZIMARY CONTACT: 0 OWNER .,in-CONTRACTOR El OTHER(Please Specify) )NT7T NAME: CONTACT PHONE; LL G, t �IU�-e- l l� CONTACT EMAIL: REEMENT. Thereby certifij that/have read and examined Phis appkcation and knotsr the same to be true and correct. All provdsbns o' d o nances g�eming of work w q be completed whether specified herein ornot. The granting ofa permit does not presume to give authori!yto vio,ate orcance!the this rt la.v regulztirg consfructron orthe per otconsfnrcton. That l am aufhorzed by the ownero{thi� , iply with the State Contractors Law 18.27 RCW and 296.200 WAC. property to perform the work far which application ns 01 1s made and ny other re or City of Everett Otfrciai Use only FE � U6 . 6o PERMIT# -7Aoi�Ient�l reE ibU3r Date