4125 GRAND AVE 2018-01-18 - Laserfiche WebLink

� �ELECTRICAL 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: 4�2�J GCaf1CI AV@, Everett, WA 98203-2225 BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: QI SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL usE oF aui��iNG: Single Family Residence ELECTRICAL APPLICATION INFORME\TION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: 60 Amp Temporary Power Pole `CONTACT 1NFORMATION OWNER NAME: John Mustach TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReer P.O. Box 12176 �,n Mill Creek STATE WA Z,P 98082 owNeR PHONE: (425) 244-0549 owNER Ennai�: John@Signat�are-Homes.net CONTRACTOR NAME: �011fl MUStaCh CONTRACTOR ADDRESS: sTReET P.O. Box 12176 c,T,, Mill Creek STATE WA Z,P 98082 CONTRACTOR PHONE: (425) 244-0549 coNrRacTOR EMai�: John@Signature-Homes.net CONTRACTOR LIC.#(REQUIRED): SIGNAH*917KE CITY OF EVER�TT BUSINESS LIC.#(REQUIRED): 6O2 572 S73 PRIMARY CONTACT: �l7 OWNER ❑CONTRACTOR ❑ OTHER (Please Specify)_ CONTACT NAME: CONTACT PHONE: (425� 244-0549 John MustaCh coNrACT Ennai�: John@Signature-Homes.net AGREEMENT:1 hereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authnrity 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 this property to perform the work for which application is made and I comp/y with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Evereti Officia/Use Only PERMIT# � . , . E �� 0� � � � / ut ized A e t ignature Date (Revised 9/23/2016)