1125 GRAND AVE 2018-01-04 - Laserfiche WebLink

� i ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.gov/permits PR�JECT SITE INF�RMATIO�N PROJECT ADDRESS: � �25 Gf811CI AV@, Everett, WA 98201 BUILDING AREA(if residential, new construction, remodel, o�aaa�c�o�� Remodel SF BUILDING TYPE: �SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL usE oF Bui��iNc: Residential R� iden ELECT ICAL APPLICAT[ON INF�RMA7`IC1N : � CONTRACT PRICE OF WOR . $ 1,900.00� NUMBER OF DEVICES (if low olta e>: n/a FIRE ALARM? ❑YES � O ASSOCIATED BUILDING PERMIT#(if a plicable): DESCRIPTION OF WORK: 125-at11p 21eCtfIC81 p81121 I"eplaCe�7lent. CONTACT INFORMATION OWNER NAME: �III L stad TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET 1125 Grand Ave �„� Everett STATE WA z,P 98201 OWNER PHONE: �2�4�54H-H6HC OWNER EMAIL:JIII.I�/StaCI@yall00.00111 CONTRACTOR NAME: CaSaSSa EI@Ct(ICBI D@SI Cl, LLC CONTRACTOR ADDRESS: sTReET 2801 S. Alaska PI �,n Seattle STATE WA Z�P 98 CONTRACTOR PHONE: ZO6 �J9�J-�J43�J CONTRACTOR EMAIL: fY1tC8SaSS8@IlOtt1l81I.COlII coNrRacTOR uc.#�REQu�REo�: CASASED834CH CITY OF EVERETf BUSINESS LIC.#(REQUIRE : TEMP LIC. PRIMARY CONTACT: �OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �2�4�548-8686 Jill Lystad CONTACT EMAIL: �III.I stad ahoo.com AGREEMENT:1 hereby certily thai I have�ead 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 construcfion or ihe 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 Officia/Use Only _.�•�-_e�,.______�.� � PERMIT# �-- ��s — -— �� J � � E �� —�°� � Owner/Authorized Agent Signature Date � (Revised 9l23/2016)