4719 BAKER DR 2017-10-03 - Laserfiche WebLink

! • 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 �o,� PROJECT SITE INFORMATION PROJECT ADDRESS: i v/7�` O� DIS —v rei I W R 01� LD BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED 'nSnFR-ATTACHED El DUPLEX ElMULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL Al USE OF BUILDING: VA!4 y►`1 1 �Q S i ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ l COCO NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES 0,NO ASSOCIATED BUILDING PERMIT#(if applicable : DESCRIPTION OF WORK: "`&4&W N rCAA I tS -kLO 40 QI W GiV Gvt�� p CONTACT INFORMATION OWNER NAME: /� a TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET4-71qtl i::C r r VV/�fr /V]ry/}�� CITY C STATE �/V A ZIP qn OWNER PHONE: r J)2-q':;'1 0% OWNER EMAIL: `� CONTRACTOR NAME: in `'V V`R L pety cW VI IAC� � 1 C• CONTRACTOR ADDRESS: STREET /I�V7 11 1_ 1_t �- SC CITY C 1 / S STATE ZIP C19nG CONTRACTOR PHONE: CONTRACTOR EMAIL:( U Cq (� VonyfiC I 019-M CONTRACTOR LIC.#(REQUIRED): I 1`t E� ��Q v CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ( k1_0)�1_ ,p-tW0 4�QI CONTACT EMAIL: I V C m��'. AGREEMENT.1 hereby certify that 1 have read and examined this application and know the same to be true ankeorrect. All provis s of laws%abd 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 PERMIT# E� � 0 �'l ly ' jj - ' j Ownerl uthorized Agent Si to Date (Revised 9/23/2016)