10512 19TH AVE SE 2017-09-25 - Laserfiche WebLink

07/24/2017 11 : 28 #2419 P. 001/001 ELECTRICAL. PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 ] FAX 425-257-8857 j (E) everetteps@everettwa_gov] Www.everettwa.90v/perM4s PROT �M7E ILN�Ol1A ►TM�[t1.;. PROJECT ADDRESS: fl fls BUILDING ARRA(if residential,new construction,remodel,or addition), _ _SF BUILDING TYPE: M SFR-DETACHED ❑SPR-ATTACHED 13 DUPLE=X CI MULTI-FAMII-Y 0 OF UNITS: 2160MMERCIA1, USE OF 13UILDIN0: /k 6q KCAL;APp1CATlO1 >II1�OR1ylATlQN CONTRACT PRICE OF WORK: NUMBER OF DEVICES(it low vol a FIRE ALARM? Cl YES ASSOCIATED BUILDING PERMIT# If a licabfe): DESCRIPTION OF WORK: 0 V71Co 2 V4f f s 777. CC11T �I�[FOR11f�pT�0�1 ACT OWNER NAME: iv jK TENANT NAME(If Comm Clai): OWNER MAILING ADDRESS: STRFEr CU STATE 74P OWNER PHONE: LI,2g OWNER EMAIL.: CONTRACTOR NAME: A-1 Q CP i7 CONTRACTOR ADDRESS: e- OF +J crry STATE 1-dCL CONTRACTOR PHONE: Z CONTRACTOR EMAIL: CONTRACTOR LIC.iE(REQUIRE=D): ff'L&�/1 K2L.'V CITY OF EVERETT BUSINE=SS LIC.#REQUIRE ) m//o3 PRIMARY CONTACT: D OWNER Q CONTRACTOR C OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: t6 AAJ C jg/cr I CONTACT EMAIL.: AGRE5M1=NT.-Thereby certify that 1 nave read and examined this application anon know the samo to be true and aarroct All provisions of laws and ordinances governing IN& type of"I-k will be completed Whether apecffj'ad herein or not The granting of a permit doss not presume to give authority to violate or cancel the provisions of any other state or local law regulating consttuctlan or the performance of construction. That I am authorized by the owner of this prnpe/9y to perform the work for which applicaflon is made and i comply with the State Contractors law 18.27 RCW and 21a&200 WAG City of J='vsrett Official Use Only FEE E p,' - 15� Owner/ ed AgentSlgnature Pat (Revised 10/12/2015)