5029 W VIEW DR 2018-02-09 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 5029 5t V t ew £,r BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE:XSFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION'INFORMATION CONTRACT PRICE OF WORK: $ 252 .o0 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: i L li..'.. / f. _.. it CONTACT INFORMA`rION OWNER NAME:clan/ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET5Q 9 � t V''e.1-.4,) Or /� +G� C TY / STATE A" ZIP qg zo OWNER PHONE: 1 2✓ 259 0 5S 8 OWNER EMAIL: CONTRACTOR NAME: c,,r6C 0 9 CONTRACTOR ADDRESS: STREET LiI5- WOadke ) t� fl� }!«y�^��QT n/� �^y CITY S�/`-�L.�t�S.,�l t STATE WA- ZIP 6R 20 1 CONTRACTOR PHONE: 1-05 t.71J CONTRACTOR EMAIL: (�C.L.v e G of h�Tc .9 r S J V_v7 CONTRACTOR LIC.#(REQUIRED):Ci he. *(b-7i d et CITY OF EVERETT BUSINESS LIC,#(REQUIRED): t.OQ PRIMARY CONTACT: 0 OWNER r1CONTRACTOR 0 OTHER(Please Specify)___. _ CONTACT NAME: CONTACT PHONE: L 35C1 DI Ie CONTACT EMAIL: a' t V3It •Ce rn AGREEMENT:I hereby certify that I have read and examined(his 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 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 by the owner of this property to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# Pa2L4- 7. 17 Ep .1II- o(P Owner/Authorized Agent Signature Date (Revised 9/23/2016)