1617 SILVER LAKE RD 2018-03-09 - Laserfiche WebLink

_r 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 INF• MATION p o. PROJECT ADDRESS: 16� 7 5 /ve✓ LK. /\ C &vc re-H- 1„/A- 981 O`/7 BUILDING AREA(ifresidential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Li lit 461 ELECTRICAL APPLICATION INFO I' ATION CONTRACT PRICE OF WORK: $ , NUMBER OF DEVICES (if low voltage): FIRE ALARM? ZYES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �-(1JGYt p1 F, 141bcI w - CONTACT INFORMATION OWNER NAME:NUT ,,c jig/lih TENANTNAME(If Commercial): OWNER MAILING ADDRESS: STREET 1617 S I 1 VG✓ 1.-t'`.• /`.Pr // CITY VGrtt t STATE ZIP S v,,Z 6-7 OWNER PHONE: y 2.5 3 t 5 71 L- 'OWNER EMAIL: CONTRACTOR NAME: /1.I Gl'l,m r�I CONTRACTOR ADDRESS: sTRE — �y �?�6 T-1,‘ y7' S ti✓ coy aft t4,1171 141 /(//h�� t STATE Lt/ 1— ZIP 11-,50 ?_g CONTRACTOR PHONE: 2_©�q 211— / b /f CONTRACTOR EMAIL: L 1 —RP/ St", lit G f CONTRACTOR LIC.#(REQUIRED): C fi tk M Ej t 0 D f v CITY OF EVERETT BUSINESS LIC #(REQUIRED) C7(19 7 PRIMARY CONTACT: ❑OWNER I2f CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: • 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 l am authorized by the owner of this properly to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# E1 7 1 \`' In Owner/Authorized Agent Signature Date (Revised 10/12/2015)