926 WETMORE AVE 2018-02-12 - Laserfiche WebLink

!ELECTRIICAL PERI Ii I1T AP!LQCQTION rcr 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 www.everettwa.gov/permits • IP f2 OJIECT SITE I INIFO z MATZO PROJECT ADDRESS: -I J ave ve r C7 ' BUILDING AREA(if residential,new construction, remodel, or addition)id 4) eri7;4 L SF BUILDING TYPE: ❑SFR-DETACHED El SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL AIPIPLICAT •N INFORMATIO CONTRACT PRICE OF WORK:$6 QQD NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: . 2,00 0 /14/ S E'✓(/t C kilbV'42- C742 1- T -(L - LSI/1 /°rte, CONTACT-INFORMATION OWNER NAME: 5 7c.vc E Gf rfr/`-C_ TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET q 24 Wer , r e CC/' re 1 ynY STATE WA. Zip q� 2o1 OWNER PHONE: OWNER EMAIL: - CONTRACTOR NAME: Go/'1"7G1-7 ul47V/ C' L CONTRACTOR ADDRESS: STREET P, 0 1-66/c 2 At La � CITY STATE -f ZIP 9'2 PS CONTRACTOR PHONE: / 2. -Z/ 2-6 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED) A e LS CS R`r6 3 N Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 5 750 5 PRIMARY CONTACT: Cl OWNER IINTRACTOR 0 OTHER(Please Specify) CONTACT NAME: C01'7 i4/(-01( 7/ ilecrrjcCONTACT PHONE: y - q3 t 2.6 jJ d 1/N CSOA CONTACT EMAIL: AGREEMENT.-T 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 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 FEE LODI I PERMIT# / - 17Efl ( 1- Z2,0 • :*Authorized Agent Signature Date.•, (Revised 10/12/2.015)