5121 DELAWARE AVE 2017-08-17 - Laserfiche WebLink

06-19-' 17 11 :07 FROM- T-104 P0001/0001 F-266 I&LECTRICAL PERMIT APLICATION 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: BUILDING AREA(if residential, new construction,(emodel, or addition) 'f S!A(-,;,)JI c,�t._ SF r J BUILDING TYPE: 19tFR-DETACHED ❑SFR-ATr'ACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: G� ELECTRICAL 4PRLICATION`IN.FORMATIO.�I CONTRACT PRICE OF WORK: $ ( 9 to NUMBER OF DEVICES if IoW voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: e { L i t _C_ �aCLg_,5_z_, CJ re_c_;e �, . 'CQNTAGT LNFORMIITION OWNER NAME: ; 4,, Ph; L_L, S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTRF;FT S(Nm _ c&-,,), CITY STATE ZIP OWER PHONE: 1,. --3&0`- 7 8 OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS= STREET A VL L.z , ! // CITY W/0 )(I-) n CI); STATE ZIP CONTRACTOR PHONE: - - 70 0 C) CONTRACTOR EMAIL: ry)r�L_ ,L c.�..Thi�C.ro� Y rS<r . yx: CONTRACTOR LIC.#(REQUiRED):r I ALL n 0 (2- CITY OF EVERETT BUSINESS LIC.#(REQUIRED):O CI` PRIMARY CONTACT: ❑OWNER EP60NTRACTOR ❑OTHER(Please Specify) CONTACT NAME: ��rile I b yj j CONTACT PHONE. g.�J_ -7 44 7 p p O CONTACT EMAIL: mrd � rZ ( � <.. AGREEME=NT:I hereby certity 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 or not. The granting of a permit does not prssuma to give authority to violate or cancel the provlslons 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 worts for which application is made and I Comply with the Stats Contractors Law 18.27 RCW and 296.200 WAC. City of IM veren Official Use Only PERMIT# b Z OwnerlAuthorized Agent Signature Date (Revised 9123/2016)