400 SMITH ISLAND RD 2017-08-11 - Laserfiche WebLink

. 7 OELEGTRICAL PERMIT *PLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)420-257-8810 FAX 425-257-8857 ] (L) everetteps@everettwa.gov] `rvww.everettwa.gov/permits SL PROJECT ADDRESS: `00 Qd BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED Q SFR ATTACHED ❑DUPLEX ❑MULTI-FAMILY-#OF UNITS- P-60MMERCiAL USE OF BUILDING: - . lE CONTRACT PRICE OF WORK:$ D 000 NUMBER OF DEVICES (if low voltage): — �/, FIRE ALARM? ❑YES O ASSOCIATED BUILDING PERMIT#(if applicable): I DESCRIPTION-OF?;WORK: FOW COI+ITACT�INFORNIATI011NE R NAM1r rzr TENANT NAME(If Commercial): NER MAILING ADDRESS: STREET .2 .. CITY - .. .. STATE t !: ZP Y 9—ZC� OWNER PHONE: `Y1 Z4-0 —/S-/D OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: s tic r�4c/ 1� CITY OF EVERETT BUSINESS LIC.#(REQUIRED): CONTRACTOR LIC.#(REQUI�tED}; �I fr _ - pRIMARY CONTACT: ❑ OWNER ❑CONTRACTOR ❑OTHER(Please Specify) Gc CONTACT NAME: CONTACT PHONE: yZ j- O / CONTACT EMAIL: a t�� uje e- .pkv t vCt a 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 ordinances governing this type of work will be completed whether specified herein ornoL The granting of a permit does notpresume to give authority to violate or cancel the provisions of any other state or local iawregulafing construction orthe performance ofconstnrction. That am authorized by the owner of this property 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 E �j 6 Owner/Authorized Agent Signature Date (Revised 10/12/2015)