1005 CHARLES AVE 2018-01-22 - 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 PROJECT SITE INFORMATION PROJECT ADDRESS: /005- Cr'f71,4AL(=-� Al JE -fV 6UN y 9ZW BUILDING AREA(if residential, new construction, remodel, or addition) Z/Q SF BUILDING TYPE: N SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL [US7EOF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: r-_v-5(QL.0 'IV oo K / AZA GLQ 0 PC P4ACCJ= /-= C S cs.!(tvC-, A(-3 0 66.40 e—t^b St feil (e,, i 1`f AJZCU CONTACT INFORMATION OWNER NAME: F_�Z17t,1S TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /pp®a�c)!� -, (kfA1Z�,I 'S� 'J L CITY CV"eA STATE 6L_?At ZIP OWNER PHONE: Zt--X5 -a i 7 OWNER EMAIL: CONTRACTOR NAME: /y G/ICJI /�'t.(^1.f�� ( L�� 1"( ' CONTRACTOR ADDRESS: STREET CITY 45 05,P STATE ZIP 7-0 CONTRACTOR PHONE: 'faS 30 - -� CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): M IL6. CITY OF EVERETT BUSINESS LIC.#(REQUIRED):`O 3E,3`f C PRIMARY CONTACT: ❑OWNER r9CONTRACTOR ❑OTHER(Please Specify) a CONTACT NAME: CONTACT PHONE: tfz$- c30 C�f2 J iM (Gly KkC (_,N CONTACT EMAIL: _ AGREEMENT.Thereby certify that/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/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 00 PERMIT# bvvKerlAuthorized Agen Ig t re Date (Revised 10/12/2015)