4724 GARDNER AVE 2017-11-28 - Laserfiche WebLink

ID • ELECTRICAL PERMIT APPLICATION 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 1 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ( �� ClarrieleJ�aVF TEVereJt G ar),3 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: QQ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: L I6m `ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WO : $ gC.�3 , �� NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES X NO ASSOCIATED BUILDING PERMIT-it(if applicable : DESCRIPTION OF WORK: Odd COr t lir tw - ' ub d i 3c t1' * CONTACT INFORMATION OWNER NAME: l r )111'll°V Irta C1\j Y'b TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CH (--' Caaide IT CAVA �( CITY 4EJ tit STATE W)`^k ZIP uS O 3 OWNER PHONE:g3\--14-4- 9 OWNER EMAIL: CONTRACTOR NAME: tL15 ) ri-ninn CONTRACTOR ADDRESS: STREET gIJOr S lJ JI4 " • ► 1 u CITY FY e t STATE �a zip 1i a�� CONTRACTOR PHONE:(-11 too ,1 'CONTRACTOR EMAIL:1 )0 '() ,d lnfl 6®J2'y1 'J1 CONTRACTOR LIC.#(REQUIRED): a�iAn ,L.� .(4.44 F CITY OF EVERETT BUSINESS LIC.#(REQUIRE3):� i= Lt Th9 I PRIMARY CONTACT: WOWNER 0 CONTRACTOR 0 OTHER(Please Specify) of-#J,Q ) CONTACT NAME: rQYl s3 CONTACT PHONE: L - 111-9---...4-g(. = �G�� - - CONTACT EMAIL: AGREEMENT:I hereby certify that I 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 PERMIT# L-41Th -11i �� . -) G - I - E VOg -- 23 Owner/Aa korized Agent Si. Date (Revised 9/23/2016)