2702 BROADWAY 2017-11-28 - Laserfiche WebLink

S 1111 4trr ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov I vvww.everettwa.gov/permits ,, PROJECT SITE INFORMATION PROJECT ADDRESS: "Z...-7(� Z <<�,.e Q ��,_�,'�y BUILDING AREA(if residential, new construction, remodel, or addition) � c& SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: IOMMERCIAL USE OF BUILDING: A'O ‹.4-4y., rQc.KA s _`` i, ELECT • CAL APP CATION INFORMATION CONTRACT PRICE OF WORK: $ _9 f `j tiO c' c' NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES ❑ 0 ASSOCIATED BUILDING PERMIT#(if ape icable): DESCRIPTION OF WORK: CONTACT INFORMATION OWNER NAME: /)/J i<leS-.74,4�s,<A4_. s TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITYCISTATE ZIP 3D OWNER PHONE: -'g'(-710`-710 SSS OWNER EMAIL: CONTRACTOR NAME: / 1 / L-1; c_74,,e(c ( S4 L./(-Le.s / /AJ C CONTRACTOR ADDRESS: STREET 76 / K - Z 7 , „</1---- A,,(7 K:,.!( +ci TY STATE A/ ,j�r ZIP ?ZS . CONTRACTOR PHONE: �6 O _=�� CONTRACTOR EMAIL: (6j CTS'- <6()O s ,' :. '4 CONTRACTOR LIC.#(REQ4. 9): ` _ --5As242-CITY OF EVERETT BUSINESS LIC.#(REQU j D): All P. PRIMARY CONTACT: ❑OWNER _u /•'TRACTOR 0 OTHER(Please Specify) ( "'L 0 Ow CONTACT NAME: cCONTACT PHONE: C..(4- -!3 g — -9 SC /�tr,,Lc o/Q_ / o - ,e� (sam/ �� CONTACT EMAIL: .e.„7,7 C 7/./‹..r L -.6e0,4_,--4 ,,e , C aez), AGREEMENT:1 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/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 ROW and 296.200 WAC. City of Everett Official Use Only PERMIT# 7::_-7{,7,66,---- -7 - ..:----‘7.- 14,_!2- .o-/..s--/77 E ‘,q(Dg ___ 9 Owner Authorized Agent Signature Date (Revised 9/23/2016)