2715 EVERETT AVE 2017-10-18 - Laserfiche WebLink

SECTRICAL PERMIT AOOLICATION 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: 7 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: MICOMMERCIAL USE OF BUILDING: v/114 r��L.i4 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ '— NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES aNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �� I x rr.►�t�3t LJ{.W T jJM� /IJ .� its !��` �A; CONTACT INFORMATION OWNER NAME: : r144t4 /{4/51/ /4 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET A It y T %,rsw rr AV CITY " Vj;'d'C rr- STATE '✓ "� ZIP J OWNER PHONE: l( �7 '330 -3'n) OWNER EMAIL: CONTRACTOR NAME: 0 14 NL F-L se-?✓t,C CONTRACTOR ADDRESS: STREET �" �1 l3 ISI KJp�L�rit L yr )" iv- CITY /��!(r.e L'; j"r' STATE W � // ZIP Y {� CONTRACTOR PHONE: -14,9 1 - 0--/C CONTRACTOR EMAIL: -evL - ,4 h 1 ✓►L. Lcm CONTRACTOR LIC.#(REQUIRED): {-41 I 414 Q0 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): ,2707q PRIMARY CONTACT: ❑ OWNER IdI.ONTRACTOR ❑ OTHER(Please Specify) CONTACT NAM CONTACT PHONE: D A �l�v�'rir4 S CONTACT EMAIL: e✓CN3 14 fe le 4 CC4`1 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 -1a,C? ® PERMIT# E ((,e19 170 Owner/Authorized Agent Signature Date (Revised 10/12/2015)