3316 OAKES AVE 2017-07-13 - Laserfiche WebLink

ECTRICAL PERMIT APPICATION 0!#1-77- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 { FAX 425-257-8857 1 (E)everetteps@everethva.gov I www.everettwa,gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: -331(o OC:Lxes Q vf, BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL.APPLICATION INFORMATION CONTRACT PRICE OF' $ , NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if a2plicable ,, DESCRIPTION OF WORK: I&M eje*; clas `1 week, MCI 9, g 1 CdNTACT INFORMATION OWNER NAME: (r,. C7 L-S cD Q TENANT NAME If Commsrelal : OWNER MAILING ADDRESS: STREET CITY STATE -J OWNER PHONE: H22 a U- Q_n OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET ` CRY STATE ZIP ' 4) ' CONTRACTOR PHONE: { CONTRACTOR EMAIL: ' CONTRACTOR LIC.$(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): eci PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Li ' i li� � �' �� CONTACT EMAIL: a . � �, � � C_z,i Y AGREEMENT:Thereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and o;,di'rTSnc&s 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 t comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/Authorized Agent Signature Date (Revised 10/1212015)