4600 S 4TH AVE 2017-09-25 - Laserfiche WebLink

• 0 ELECTRICAL PERMIT APPLICATION 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: • 4/rtl Aixc– 1 1, ,-j. BUILDING AREA(if residential,new construction,remodel or addition) .. SF BUILDING TYPE: ❑SFR-DETACHED ® SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING- '/ItLECTRtCAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: t4 / NUMBER OF DEVICES if low olta e : FIRE ALARM? ❑YES ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: .u_-07' CONTACT INFORMATION OWNER NAME: Pr = ` t} TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET I LPOC) S- L _ ................. CM, Li 7 STATE; /* ZIP OWNER PHONE: OWNER EMAIL: h.&'TLi Ls /G Cts CONTRACTOR NAME: ti CONTRACTOR ADDRESS: s'rReEr CITY STA.TF ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: [9OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: VAAJC_ ll(�,- _ F1CONTACT EMAIL: AG?ll 1;tvI w7 1 hereby certify that i have read and examined this application and know the same to be true and correct. Alf provisions of laws and ordinances governing this type of svor„wiP be completed whether specified herein or not. The granting of a permit does not presume to gwe authority to violate or cancel the provisions of any other state or i w rc gulating construction or the performance of construction. That I am authorized by the owner of this property to perforin the worn for which application is made and I compiy with the State Contractors Law 18.27 RCW and 238.200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature ate (Revised 912312016)