3601 SHORT ST 2018-02-26 - Laserfiche WebLink

�ECTRICAL PERMIT AI° LICATION CITY OF EVERETT PERMIT S{ 'VICES 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: 43�Q 1 Skr� S BUILDING AREA(if residential, new construction, remodel, or addition) _ SF BUILDING TYPE: ❑ SFR-DETACHED j/SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: NatitS-t ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ lacc() NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES I�NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: /J q t„) pci-rt.eJ / /Aft,r � CONTACT INFORMATION OWNER NAME: 'lo,:/>e__ ,17.wLP.Sr9v1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 36- -I— 3T- CITY Ft.t re +frSTATE wZIP OWNER PHONE: OWNER EMAIL:9 CONTRACTOR NAME: (3y'P�h (y t E-10 ) 4e LCA CONTRACTOR ADDRESS: STREET ) /ct_ ,�Q 4� S{ CITY STATE L ZIP qJs 02?CJ CONTRACTOR PHONE: a0 G -`J'7 J 53 5 CONTRACTOR EMAIL: ��y�p„� �; q yam, co -- CONTRACTOR LIC.#(REQUIRED) PL� (� R-qQ /V CITY OF EVERETT BUSINESS LIC.#(REQUIRED) O5 3 _S 1 PRIMARY CONTACT: ❑ OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: e, CONTACT PHONE: G _ z -�) F 1u CONTACT EMAIL: ��„ (��,(eI ,,j/ /r, , AGREEMENT.'T hereby certify that I have read and examined this application and know the same to be true and correct. Al!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, OO PERMITT# 1 . o Ek()L 111 Owner/Authorized Ag-nt Signature Date (Revised 10/12/2015)