10803 4TH AVE SE 2017-09-25 - Laserfiche WebLink

f ' ELECTRICAL PERMIT AP 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 wvvw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT AID DRESS: j U U —a' w S �, cl&`1ol BUILDING AREA(if residential. new construction,remodel,or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#CF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: S T030 '— NUMBER OF DEVICES (if low voltage)-. 1 — i FIRE ALARM? ❑YES XNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: v'Ce t j 5h,1 r MC)S'76� qd1 C CONTACT INFORMATION OWNER NAME: t)qq TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET I o O d M � xx CITY STATE ZIP U OWNER PHONE: L4-'I'S �j ' //q, OWNER EMAIL: vJ CONTRACTOR NAME: L /1 OVI P CONTRACTOR ADDRESS: STREeT It Iz- Crr,Y f t—,2(,tip I CI L STaTE CONTRACTOR PHONE: 11 ^ -�j CONTRACTDR EMAIL:YI (1'j�Y/� L'G oL �1CXJ CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR 1A OTHER(Please Specify) dwt�2r �k - CON NAME: CONTACT PHONE: (' S _ 9200 coNTACT EMAIL: Y AGREEMENT.,Thereby certify that I have read and examined this application and know the same to be 6e,and correct. Ail provisions of laws and orziinan---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 t am authorized by the owner orthis property to perform the work for which application is made and t comply Mlh the Stale Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE C PERMIT# E ownerlAuthorized Agent Signature fate (Rovfsed 10/12/2015) ( d e09:7,0 91, £ Int