2204 GIBSON PL 2017-11-28 - Laserfiche WebLink

k*Fm. •ECTRICAL PERMIT AillkLICATION 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2_2-( bS Dr\ P L EVQ TQ-Ct"I V\(� oi$20� BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED("SFR-ATTACHED 0 DUPLEX 1:1MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: SFR. &c lc.( T" V kyr a1/43 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ , ®OQ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES RC1 NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: l n S-}-c r bOft p c dcLc h' V S' s-k- '-'c ' l b ( n c_l u cte, (32_ F _y 300 SE x u C9L9 ( So - r'‘a_ *9 (COO 3V1\g ittl\1Q cQ/ Sy-voT \P—dk cic, \'Y\O V etti CONTACT INFORMATION OWNER NAME: L0 .1q TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Z-2OL( G i p CITY EV(LrQ.H STATE vv A ZIP '"l O 2 O 3 OWNER PHONE: El ZS-) 2-1 D — 53 0y OWNER EMAIL: ►"Fk ri r'L9 f o vri-i 2►' . Cil 1'1 CONTRACTOR NAME: N VLS- LriA CONTRACTOR ADDRESS: STREET 41 0'1 I 44.01-Y% 12-0 S-±-1' A. 4 CITY t 1(r i l'1.6\1\-0-01_ STATE WA ZIP 9(> 224, CONTRACTOR PHONE( ,4�7`1(z d S S9 CONTRACTOR EMAIL: 1 rf C W Q Q-(n.S o 1 aJ C . CD M CONTRACTOR LIC.#(REQUIRED): \j EST 1S 1 2_DD CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 051-1 I SS PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 6u,a� 2Z ti — 3 Sal Ey( C \- r CONTACT EMAIL: er1c eS+ex,'-1SOIau^ir1C. 0r - \ AGREEMENT:T hereby certify that 1 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 lam 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 FEE PERMIT# 1011itko EJ1: 1( . /3 ? Owner/Authorized Agent Signature Date (Revised 10/12/2015)