302 107TH PL SE 2018-01-11 - Laserfiche WebLink

ECTRICAL PERMIT A�LICATION � 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 PROJECT SITE INFORMATION PROJECT ADDRESS: -''�.'.�,� I C°' �`T�1 �L "-�� i � � �C� �� !� �'� �� ,�L l``'j BUILDING AREA(if residential, new construction, remodel, or addition) �(,r` r�/C-` SF BUILDING TYPE: ❑ SFR-DETACHED SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES if low volta e): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: � �`��b �'1\c; �•^' v - - G�� C� I c� �T j - ^Cti' ctCe` y ;'{,:Cy �1 CONTACT INFORMATION OWNER NAME: ,C'',l l! J�< :c�� TENANT NAME(If Commerciaq: OWNER MAILING ADDRESS: sTrzeEr (j �I� C� ,� ��J2, J �� , CITY ��V"�"�� S?ATE �.L, ZIP C.,�� n C.�� � OWNER PHONE: ��.�`� "":��5 ,��J OWNER EMAIL: CONTRACTOR NAME: � ��'��,�� Y CONTRACTOR ADDRESS: sTReer CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REqUIRED): PRIMARY CONTACT: �,OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �- ��-� �j � __,C-( � � ��Y L.�� G�� CONTACT EMAIL: �� V'�1 L� t C�,' i��15 1�1, '.�J YVl AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. AH provisions of laws and ordinances governing this rype 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 1 am authorized by the owner of thrs property to perform the work for which application is made and I comply with the State Conhactors Law 18.27 RCW and 296.200 WAC. City of Everett Offidal Use Only FEE I �� PERMIT# �� , _ �,�;7 ��,,�., ) - �� E � �c�7 i 3� � OwnedAuthorized Agent Signature Date (Revised 10/12/2015)