10330 4TH AVE W 2018-02-26 - Laserfiche WebLink

41"7 _ECTRICAL PERMIT A. . 'LICATION 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: C ?-70a? BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL ry r1 USE OF BUILDING: 1 y.41AJAC / A c( �,L\I 1.A/'i ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ //22; NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: '" hook_ K.f + ±Z OA1 r`rJ! t- 001/LGt2ait K-. o j��•L%( � �;� r� \ t•l- C (c a / t`('u ('- ki 4 ,;;GA CONTACT INFORMATION OWNER NAME: :a:4444 LL(_ TENANT NAME(If Commercial):` i(-4 ) fdtivk 1'-J* Liv� OWNER MAILING ADDRESS: STREET It Y�l.' 4411 e_ Ij ++ CITY C�I STATE I' .'�� ZIP - 11 'C `(- OWNER PHONE: - i"'`' • �' E �=, OWNER EMAIL: CONTRACTOR NAME: IQ �, � '',.(y,1 4\(I .( ,Y 'f �(6Y ' t,tdi CONTRACTOR ADDRESS: STREET rUll`v 1 ,� CITY ,�M&4- 4LL. STATE K) ZIP y7"7Q CONTRACTOR PHONE: ?_.*()O ' t jS-De CONTRACTOR EMAIL: i-V� d �41 („Y� �\ U(� y/171_• CONTRACTOR LIC.#(REQUIRED): �a' C /� 2 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER .CONTRACTOR 0 OTHER(Please Specify) 'CONTACT NAME: CONTACT PHONE: • / , )-- CONTACT EMAIL: ^ ', C ( l tz) dame i r AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. All pro iv sions of laws and ordinT9nces 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# t( ((.;, E ( (e ( 0 - 6160,3 Owner/Authorized Agent Signature Date (Revised 9/23/2016)