4632 FOWLER AVE 2018-01-31 - Laserfiche WebLink

�ECTRICAL PERMIT AP�ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@everettwa.gov � wuvw.everettwa.gov/permits PROJECT SITE INFORMATION PRo�ECTanoREss: 4632 Fowler Ave Everett Wa. 98203 BLDG BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL use oF Bui�oiN�: Multi Famil ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 5189 NUMBER OF DEVICES if low volta e : 2 FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT# if applicable : DESCRIPTION OF WORK: 3 Cat6 Cable, CONTACT INFORMATION OWNER NAME:WOOCJIlBVG'Cl APaI'�1112f1tS TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReer 4632 FOWIeC'AV@ �,n Everett STATE �Na Z�P 98203 OWNER PHONE: 4Z�J-�J69-H77O OWNER EMAIL: CONTRACTOR NAME: Sk�/IICIe C0171171UIlICatIO11S IC1C CONTRACTOR ADDRESS: sTReEr 12002 Beverly Park Rd. �,TM Everett STATE Wa Z,P 98201 coNrRacroR PHONe: 425-355-1593 CONTRACTOR EMAIL: Summer.Sherriff@Skylinecommunications.net coNrwacTOR uc.#�REQu�REo>: SKYLIC1933Q7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED):4�OrJ�T PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 42�j-3rjrj-�rj93 Summer Sherriff coNracrennai�:summer.sherriff@skylinecommunications.net 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 goveming 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 6y the owner of this property to perform the work for which application is made and I comply with the State Contracfors Law 18.27 RCW and 296.200 WAC. City of Everett O�cial Use Only PERMIT# - �� Il �� E i � � �� f� � Ow er/Authorized Agent Signature D e (Revised 9/23/2016)