13110 19TH AVE SE 2017-09-25 - Laserfiche WebLink

I&ECTRICAL PERMIT APIOCATION 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 ADDRESSAI AVD \ e\le''et 1Aw . BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: JXCOMMERCIAL USE OF BUILDING:WQ\ (CCA 5 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 6'_50c) NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: i IUMI je C'jall Z fr'Vrriar la0,-7J 11121-eZkoAd Il s f we Sf Yi �1 CONTACT INFORMATION OWNER NAME: Evere R LLC, 2 TENANT NAME(If Commercial): 1 tee ns OWNER MAILING ADDRESS: STREET klW DOV1001 C►Ci �A�S Dr. CITY . ora-QI Anon STATE C ZIP _IL 105 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 1 SI n OVlj � &JC4- Sin CONTRACTOR ADDRESS: STREET EGOS HW"I GIq SO. `_,Aµ QQ�f�]2 CITY 1 \A • V`evno v1 STATE vv/\ ZIP `U L • J CONTRACTOR PHONE: (3 co) qtq- 13Z✓ I CONTRACTOR EMAIL: 8�e�ar.ICC� Y�1C efb v1.�owl CONTRACTOR LIC.#(REQUIRED): �AEYEvSGOnGL{ CITY OF EVERETT BUSINESS LIC.#(REQUIRED):[) U PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONT1ACT NAME: CONTACT PHONE:(�j��r yZy- I?>.L5 5+�ylie Livicgvi6+- CONTACTEMAIL: S{et�nleC� C I V1 •Coves AGREEMENT:T hereby certify that 1 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 I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# 7 i 116 EIh I I � OwnerlAuthorized Agent Signature Date (Revised 10/12/2015)