2131 BAKER AVE 2017-08-08 - Laserfiche WebLink

ELECTRWAL pERNT APPLICAMN 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 INFORMATIO PROJECT ADDRESS: BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLU, ❑ MULTI-FAMILY- F UNITS: ❑COMMERCIAL USE OF BUILDING: !ELECTRICAL APP (CATION INFORMATION CONTRACT PRICE OF WORK: $ �� v NUMBER OF DEVICES(if low voltage): y— FIRE ALARM? �I YES NO ASSOCIATED BUILDING PERMIT#(if applica e): DESCRIPTION OF WORK: & CONTACT INFORMATION OWNERNAME�EA&lj �O=�J�L-sem TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �-t � S CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET \,'2--(Z CnY 1 N i D STATE ZIP k>22— CONTRACTOR PHON Z0 CONTRACTOR EMAILSv1/I 2�Ci ��f�� L R LIC.#(REQUIRED) --��2U�Sj CITY OF EVERETT BUSINESS LIC.#(RE IRED):�NTACT: ❑OWNER i3-CONTRACTOR ❑OTHER(Please Specify) ME: CONTACT PHONE: ��D l7'� _ 3-7S-5 CONTACT EMAIL: OT!� C G G AGREEMENT.T hereby certify that l have read and examined this application and know the same to be true and correct. All provisions of laws a d 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 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 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT 4D�/ Erized Agent Signature (Revised 10/1212015)