1041 CROWN DR 2017-08-10 - Laserfiche WebLink

SLECTRICAL PERMIT AOLICATIO CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, FVERT=TT, WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettWa.gov www.eVere#W2_g0v/perm1tS - . . P;�®��s��.�ll� tIYG^��3iVd�►`iI�II��.° , PROJECT ADDRESS: V - u� t v� 13UILDING AREA(if residential, new constCl ejoo, remodel, or addition) SI BUILDING TYPE: n SFR-DETACHED SFR ATTACHED Cd DUPLFX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: �LtdtkICAL APPLIC At'10" IfNFORMA"fi®N CONTRACT PRICE OF WORK:$ ;L 2, NUMBER OF; DEVICES (if low voltage). — FIRE ALARM? fl YES O ASSOCIATED BUILDING PERMIT#(if applicable): N DESGRIPTION OF WORK: Yid cam"' � &.Ib k ACT:wia MATT O�I r OWNER NAME: u e S TENANT NAM) If commercial): K►(A OWNER MAILING ADDRESS= sTeear Z)9405' orry STATE (,,> �p 3 OwNER PHONr-: (o . IOWNEa EMAIL: 5 �m n CONTRACTOR NAMV' CONTRACTORADDRrESS: sTREETZ>di�)ZU CITY O T +- STATE LPA XIP CONTRACTOR PHONE, 4--D,:-- l CONTRACTOR EMAIL; e,0 C4P CONTRACTOR LIC.#(REQUIRED)• CITY Or EVERETT I;IUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: C[ OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME.: CONTACT PHONE: CONTACT EMAI114 . AGREt tvfF�VT:T hereby certify that'have reed and examined thfs appkoation and Mow the same to be fire and come . All provisions oflaws and ordinances goveming this fyp¢pf yrorl(wilt be completed Whether spe4i7ed herein or not- Tha granting'of a permit does notpre'sume to give aOhcAtY ro violate orcanoel the provisions of enyOther staE9 or 100.9/law regu1atln9 construction orthe performance of construction. That/am authorized by the owner of this property to perform the work for which appUOation is made and 1 comply with the state Contractors Law 1 a,27 RCW and 286.200 WAC. City of Everett Official Use Only SEE PERMIT## Ovrne uttior3ze AgePt5lgnat�rB Date (Revised 10/12/2015)