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5124 SEAHURST AVE 2017-09-22
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5124 SEAHURST AVE 2017-09-22
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Last modified
9/22/2017 11:54:01 AM
Creation date
9/22/2017 11:54:00 AM
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Address Document
Street Name
SEAHURST AVE
Street Number
5124
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OECTRICAL PERMIT APIOICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ` - <br /> S_�k>i1-}j t i ft S r-- iO it C F c <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ f 6-o <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? ❑YES '�"O <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: _i i r o c <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: SrREET �j j .+ �t i r )�✓`' <br /> CITY Cvc.z c. r STATE I-A zip <br /> OWNER PHONE: l \S �' >L- C�G� 3 OWNER EMAIL: <br /> CONTRACTOR NAME: E=LE- c7 CGLL <br /> CONTRACTOR ADDRESS: STREET t Z 6&'` e�} <br /> CITY L"fz-L--C.-�'G+�1J STATE 1.1�� ZIP Gj-6eF,3 <br /> CONTRACTOR PHONE:_'-��-.") 3i-5 — CONTRACTOR EMAIL' iCC-d—VA--l�iC,""-C.,,'Vli)-T_.i , tr�t' <br /> CONTRACTOR LIC.#(REQUIRED):� r Jt E .��jS D(--- CITY OF EVERETT BUSINESS LIC.#(REQUIRED):05-T—I t Z <br /> PRIMARY CONTACT: P OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> AGREEMENT:I hereby 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> l <br /> Owner/Atithorized Agent Signature Date (Revised 9/23/2016) <br />
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