1314 COLBY AVE 2017-10-17 - Laserfiche WebLink

0 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 I www.everettwa.gov/permits PRQJECT.SITE,INFORMATIO . .. ..... ... PROJECT ADDRESS: 1314 C Q 1 BUILDING AREA(if residential,new construction,410del.or addition) SF BUILDING TYPE: SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELECTRICAL'APPLI CATI©N INFORMATION CONTRACT PRICE OF WORK: $ C� ,o0 NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: n . CONTACT INFORMATION' OWNER NAME: TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREETLb e, rn-YGverloTt- STATE W A ZIP OWNER PHONE: 1425 51OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET '-) )Lil5 W CITY STATE +A_ zip 201 CONTRACTOR PHONE: "'► 095b CONTRACTOR EMAIL: , �Q Vyl CONTRACTOR LIC.#(REQUIRED):C.Y he i! -1dIII CITY OF EVERETT BUSINESS LIC,#(REQUIRED): PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �l5 CONTACT EMAIL: a�qUt�7t�, (10rn� ,Clt "n AGREEMENT I hereby certify that f 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 speclfled 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 16D 91-17 OwnerfAuthorized Agent Signature Dale (Revised 9/23/2016)