7212 7TH DR W 2017-10-25 - Laserfiche WebLink

0912s/2017 14:55 42ss2 P. 001/001 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PI=RMIT SERVICES OL 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 1 (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT ADDRESS: > BUILDING AREA('rf residential, new construction,remodel,or addition) gF BUILDING TYPE: FR-DETACHED ❑SFR-ATTACHED M DUPLEX 13 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL U5E OF BUILDING:, Ilk W *P-LICAnjo FORMA CONTRACT PRICI=OF WORK:$ — NUMBER OF DEVICES if low voltage): FIRE ALARM? 0 YES 13 NO ASSOCIATED BUILDING PERMIT# if applicable). DESCRIPTION OF WORK: 1� - . :• - • ' ' • : .".':.�QNTAs�T.I,N�Oi�ATIt?N'.-. . ,. OWNER NAME: TENANT NAME(if Commercial OWNER MAILING ADDRESS: STREET cm $TATE ZIP OWNER PHONE: S OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRE=SS: $Tar CRY STATE ZIP CONTRACTOR PHONE: coNTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF WERETT f3USINLSS LIC.#(REQUIREo:6/4,✓ PRIMARY CONTACT: ❑OWNER O CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: JOd& CONTACT FMAIL: AGREEMENT,I heroby can y vW 1 have read And examined this appl7cation and know the same to be true ane Carr0a all provisions of laws and ordinances governing this type of work will be completed whether speffood herein or not. The granting of a parmll does not presume to give authonly to violate or cancel the provisiow of any other state or local law regulating construction or the performance of uonstnldiOn. That I sun autrrorized by the owner of this property to perform qac work for which application Is made ami l comply with the State Contractors Law 18.27 RCW and 288.204 WAC. City of Everett Official Use Only PERMIT# Own uthorixed Agent Signature Aate (ReviBAcf 9/23r1p16)