8717 10TH DR SE 2017-10-25 - Laserfiche WebLink

® 0 ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: (� c/ !L- BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: !4 L T ELE CATION INFORMATION CONTRACT PRICE OF WORK: ,3- NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES 12 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: �/ - P77-- ` TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET " ' `i Q/7 - CITY /7 -CITY ��` STATE ZIP OWNER PHONE: 7 7'5V' v�� OWNER EMAIL: CONTRACTOR NAME: C -.T • /Z_ - L Z(__ lrL C_ CONTRACTOR ADDRESS: STREET V5�' `E�� /�3�r�y� L "OV, CITY Z�✓ `�✓t!J/'VW y STATE ZIP CONTRACTOR PHONE: ,�F 623,23 Y V-57 CONTRACTOR EMAIL: Cy, hly - CONTRACTOR LIC.#(REQUIRED): G`ILLL�G QTS CITY OF EVERETT BUSINESS LIC.#(RE PRIMARY CONTACT: ❑ OWNER ONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: o7._,2,_7o_e_75' C._ lvf-D CONTACT EMAIL: AGREEMENT. T hereby 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 l am authorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE t jl PERMIT# t V /&7_� i,6 E f Wo- 1��f Owner/AuthordLAgenlg nature Date (Revised 10/12/2015)