8123 FLORIDA DR 2018-07-11 - Laserfiche WebLink

#ECTRICAL PERMIT AlfLmICATI®IV CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS. 97/ C CJ(r"! G,, Dr BUILDING AREA(if residential, new construction, remodel,or addition) 2 2,Z)0 SF BUILDING TYPE: ❑ SFR-DETACHED ')4SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES PkNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 21.. v't TV CONTACT INFORMATION OWNER NAME: T NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 5_ fELC( E � L L-L— c CONTRACTOR ADDRESS: STREET v1 J x7 J� CITY STATE/ ZIP U Z/3 CONTRACTOR PHONE: 2� ?j �2 CONTRACTOR EMAIL: �Gt�ta� 1 L r'� -c�} ) , (y) CONTRACTOR LIC.#(REQUIRED): ' CITY OF EVERETT BUSINESS LIC.#(REQUIRED):49A5 4$8' PRIMARY CONTACT: ❑ OWNER VCONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: !'its AGREEMENT:Thereby certify th t/have read and examined this application and know the same to be true d correct. All provisions of laws and o " ances goveming 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/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 Oficial Use Only FEE ZD ® °-0 PERMIT# �' z� ls' E � fool� IgS OwnerfAuthorized Agent Signature Dat (Revised 10/12/2015)