215 W MUKILTEO BLVD 2017-08-24 - Laserfiche WebLink

SLECTRICAL PERMIT A&LICATION 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: Z 15 W MUK1l.T E:0 BILN 0 BUILDING AREA(if residential, new construction, remodel, or addition) 2--7 -7 3 Z- SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: CNVQCI-k ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ R 10 2K NUMBER OF DEVICES (if low voltage): A FIRE ALARM? w6s MNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: e_zueE - i Al_ Fo1Z REjv\oov_L A^Ao Cc vaA?r/� (biomc)A)S . CONTACT INFORMATION OWNER NAME: QUIZ SAV10\2S LUT► EaW C�1UaN TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 21`� V`.1 Mo KILTEp vc) CITY C\je -n- STATEW—A ZIP R Zb OWNER PHONE: qZS - 25z-- DN OWNER EMAIL: N CONTRACTOR NAME: FZ14 ENVk EL 21 C_ CONTRACTOR ADDRESS: STREET 6Z S0\)_P4 S\W(,e SNV IF T CITY Vt>O STATE A ZIP (XB3 CONTRACTOR PHONE: ko til A - 'z CONTRACTOR EMAIL: ejVA44% ?-HV- 6mor I c_ ,C CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER B CONTRACTOR ❑ OTHER(Please Specify) CONTACT N`A�M,�E.:' CONTACT PHONE: 3 C 0 -770 V l / r�vZA�Ix�`r AAk CONTACT EMAIL: (2 ?W- L -Com AGREEMENT:Thereby certify that/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 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/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE I , ,'_g PERMIT# uthorized Agent Signature D to (Revised 10/12/2015)