10910 HOLLY DR 2018-01-04 - Laserfiche WebLink

�EC`fRICAL PER�iII� A�'LICAT'ION 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 PROJEC'7' SITE INFORIiII�►TION PROJECT ADDRESS: i�`��,� "��j �-' �� . `�\ � �-�. 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: �y�� ,�� ra/`�� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: - "� '_� cv - 'L.., ;. � s�v�' T►� QL'��Yl CONTACT INFORMATION OWNER NAME: �g i� t='�Jv�}-F I��-�•�� , TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET � � � Z-� i n � CITY �v�1�-� �� STATE �'� ZIP � � OWNER PHONE: �'2 -Z3 �-- OWNER EMAIL: _, .. ,. _.. .. ... _..._... ... ....... .. .�,._. �.. _._ _ ...._..._ .. ..._. . _ . CONTRACTOR NAME: �� 5S /k�j F� Lj P L �_.L"� : CONTRACTORADDRESS: sTREeT �. � , � �7 �� � �/� CITY ^��`�.� I STATE �--11"f� ZIP CONTRACTOR PHONE: �- �3�- CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): �� °=�� l '�— GTY OF EVERETT BUSINESS LIC.#(REQUIRED):t�� 15 PRIMARY CONTACT: `�OWNER ❑CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: l.f.z� ,Z?J � .- �-jQ }�j �� 'j�� j�,�� CONTACT EMAIL: AGREEMENT:T hereby certify that I have read and examined this applicatron and know the same to be true and correct All provisions of/aws and ordinances goveming this type of work will be complefed whether specified herein or not. The g�anting of a permif does not presume to give authonty to violate or cancel fhe provisions of any other stafe or local law�egulating construction orthe pe�formance of construction. That I am authorized by fhe owner of fhis property to perform the work for which application is made and l comply wifh the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE � �� PERMIT# ` �\~�� /� ,� � � � � �� Owner/Authorized Agent Signature Date (Revised 10/12/2015)