3428 FEDERAL AVE 2018-03-12 - Laserfiche WebLink

_ECTRICAL PERMIT A_ LICATION '11111144 J_ CITY OF EVERETT PERMIT SERVICES vse/ 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857I (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATIONS PROJECT ADDRESS: 3.4-243 BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: 'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 6-rR. ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES KNO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: '.j ku) CONTACT INFORMATION OWNER NAME: WS N.)\i S—C \QC) TENANT NAME(If Commercial): I" [/ — OWNER MAILING ADDRESS: STREET P.©, t'J(J�G s CITY VPrL.JV l STATE, V-) ZIP l p 55-.01�1 '�+1�]t OWNER PHONE: .-36r) �D ` • OWNER EMAIL: V U 1,� `��--QJ`�ICONTRACTOR NAME: fi /`,IrlIc6;11;\! _J! ��11 CONTRACTOR ADDRESS: STREET 3 t l' Y ` ' S )94)C\&- CRY 9Y'CRY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: XOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: -360 , ! , _L e (Y\t Pra— l 1 I Z(' CONTACT EMAIL: AA C 4 (�J Mut l c AGREEMENT.:T hereby certify that I have read and a amined this application and know the same to be true and correct. All provision of laws 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 t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE an PETL:oio Ow r/Authorized Agent Signature Date (Revised 10/12/2015)