1725 MAPLE ST 2017-10-24 - Laserfiche WebLink

ic-LECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.gov/permits 4. PROJECT SITE INFORMATION PROJECT ADDRESS: j BUILDING AREA(if residential,new construction remodel or addition) e c1, SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MUL I-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ELE RICAL. APPLICAYIOM INFORMATION! CONTRACT PRICE OF WO K: NUMBER OF DEVICES(if low v Itage): FIRE ALARM? EI YES 1 ❑NO ASSOCIATED BUILDING PERM #(if app cable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET (/f+V z:'1 CrrY STATE l/ ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY rL o� STATE ( ZIP CONTRACTOR PHONE: yQs`—,Z ev '7 q fs CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRE ): 3 PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: !�a$� �(� '7�s 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 I am authorized by the owner of this property to perform the work for which application is made and t comply with the State Contractors Law 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE nerorize entS1 atu a Date (Revised 10/12/209.5)