6524 BERKSHIRE DR 2018-02-01 - Laserfiche WebLink

• • ELECTRICAL PERMIT APPLICATION CITY OF EVERE7T PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98209 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � www.everettwa.govlpermits PRbJ�C.T.SIT� INFORMATION PROJECT ADDRESS: �'�' 2 K e �t" �V W�} q g ZQ SUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: SFR-DETACHED ❑SFR-ATfACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: Cl COMMERCIAL U8E OF BUILDING: ELE�TRICAL A�'PLIGATIt�N MN�ORIV'�ATIOM CONTRACT PRICE OF WORK: $ (� .�' NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: •� caNT��cr rw�ca��n��►T�o� OWN�R NAME: � �1'"� TENAN7 NAME If Commerciai ; OWNER MAIL{NG ADDRESS: srrtE.pr � `e CfTY STATE Z!P OWNER PHONE: ,�;�3� OWNER EMAIL: CONTRACTOR NAME: � CONTRACTORADDRESS: srREer � � �Q� CI1Y � STATE .� ZIP � .�V� Ct7NTRACTI'�R PHONE: �"� CONTRACTOR EMAIL: � � , '�}YYi CC3NTRACT4R LIC,#(REQUIREt7):C.YY1�P. h �C�✓l CITY OF EVERETT BUSINESS LIC.#(REC�UiREO); Pf�tfMA12Y CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Pleass Specify), C�7#�TACT NAME; CONTACT PHONE: �� a�q �� � �:�'�,�„i�C. CONTACT EMAIL: t�.P�] �j �'1�L�1 •GOYY� AGREEMENT.•I hereby certi(y thatJ have read and examined this applicailon and know the same to be true end correcf. All provisions o/laws and ordinances goveming this type a1 work wlll be comptsled whether specl(ied herafn ar not. The granfing o!a permlt does not presume to glve aufhori[y fo vlolafe or cancel Ihe provlslons o1 a�y other state or local law regulalrng construction or(he perlormance ol conslruclion. That 1 am aufhorized 6y lhe owner of Ihls property fo perfam(ha work for wh(ch appllcatlon is mede and 1 comply wllh the Sfate Contreclors Law 18.27 RCW and 296.200 WAC. City o(EvereH Ofi]clal Use Onty PERMIT# � _,��2��r� (o•I S •I --� E l� � J l l� t')wnerlAutl�arizad Agent$Ignatura Date (Revised 9/23/201G)