2205 BROADWAY 2017-10-03 - 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( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: BUILDING AREA(if residential,new construction,remodel,or addition) SSS SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: WOMMERCIAL USE OF BUILDING: (0(2.1�__F} R' ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 8, QQQ NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑YES ZKO ASSOCIATED BUILDING PERMIT# if applicable). sCNIPT1ION OF w'ORK: � k iz ti ki L)LT/--r iu,j —Z TA—C.� C x O`L v l�ltlACT 1I►�iFORMATfON OWNER NAME: , L.1—L TENANT NAME ff Commercial): S OWNER MAILING ADDRESS: STREET / /� 2 q�yCITY )AQ-y-,LA' -A f STATE l _ TT ZP V OWNER PHONE: - J(7 I- �a Qt OWNER EMAIL: CONTP.At'rM NAASE: E C 'C CONTRACTOR ADDRESS: STREET aFu cm STATE MP 1 CONTRACTOR PHONE: '7 Z.- � CONTRACTOR EMAIL: 0,, k E0 C c, '-, P CONTRACTOR LIC.#REQUIRED:T>;:-E C_F I (2ri_0 CITY OF EVERETT BUSINESS LIC.#REQUIRED: > � PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR '21 OTHER(Please Specify) S i av E C f4QLk 1 �7� }SUN l Zr�1( t CONTACT NAME: nCONTACT PHONE: _9-S 0t.1 TACT EhWL: q t.,N i T-t . c}(F'?S.av S I A±tet 5 �. , cot-i AGREEMENT..,Thereby certify that I 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"be completed whether specified herein or not. The granting of a permit does not presume to give authority to vioiate or cancel the provisions of any other state or local law regulating construction or the peifor mance of tbnshuetion. That t am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE f/ PERMIT# Owner/Authorised Agent Signature Date (Revised 1011212015)