4841 ALPINE DR 2018-01-17 - Laserfiche WebLink

� � 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 PROJECT SITE INFORMATION PROJECT ADDRESS: : j �� ' �` ' , BUILDING AREA(if residential, new construction, remode(or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX �j MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: � �� -(�"i� �� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): � , f. — � �' _3 DESCRIPTION OF WORK: , �C�� _�— f�ir �C�� L�,"� �1"' �ylL� " G��:C� ` c��l�(� ; �c � �� , � � - � CONTACT INFORMATION ,n OWNER NAME: ; 'G�-�� G�� l'�} TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReeT C �( ' f�. /�" � C�I�'T cm �� srnTe �i,'�L(t ziP �� OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: (,.� ��v ��l.F,�I� CONTRACTOR ADDRESS: srrzee-r CI'iY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): _ PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR (�I:�OTHER(Please Specify) �b✓�t�-� Z�!Gu�"� CO ACT NAME: ^ CONTACT PHONE: "�., � `�y S �— SS�� ��- � C.� U f��`� � CONTACT EMAIL: ' ' � �,t`.� C-tr �i J ,, G� ';' C ��v�.. � G(JG""1 AGREEMEN7 JT hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of(aws and ordinances governing thrs 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 pertormance of construction. That l am au(horized by the owner of this property to pertorm the work for which application is made and I comp/y with the State Contractors Law 18.27 RCW and 296.200 WqC. Crty of Everett Official Use Only FEE ` � �� . �- PERMIT �� -� c� ��16 �� c � - 1� � � � � E O erYAuthorized Signature Date (Revised 10/12/2015)