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4205 RIVERFRONT BLVD COE LIFT STATION #42 2018-03-27
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COE LIFT STATION #42
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4205 RIVERFRONT BLVD COE LIFT STATION #42 2018-03-27
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Last modified
3/27/2018 10:59:08 AM
Creation date
3/27/2018 10:56:53 AM
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Address Document
Street Name
RIVERFRONT BLVD
Street Number
4205
Tenant Name
COE LIFT STATION #42
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�ECTRICAL PERMIT AP�ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 32Q0 CEDAR STREET, EVERETT, WA 98201 <br /> (P) 425-257-8810 � FAX 425-257-8857 � (E} everetteps�a everettwa.gov� www.everettwa.gov/permits <br /> PR�JECT SITE tNFORMATION <br /> �J- � , <br /> PROJECT ADDRESS: �C�� /C./�.�_ . ' � ' � ;%Y ,�� � <br /> BUILDING AREA(if residential,new construciion,remodel,or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#QF UNITS: �COMMERCIAL <br /> USE OF BUILDING: �,,,� �(�� <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ �� "�Q(� <br /> NUMBER OF DEVICES (if law volta e): <br /> FIRE ALARM? ❑YES NO <br /> ASSOGIATED BUILDtNG PERMIT# if a plicable): <br /> DESCRIPTI�N OF WORK: �„{ t�"c.�tt�Y'1 , _�[ �' '"�'�` ��� Z ___ <br /> _ � ,,� <br /> GONTAGT tNFI�RMATION <br /> OWNER tJAME: TEIVANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: srReEr � <br /> CITY STATE ZIP � <br /> OWNER PHONE: h� OWNER EMAIL: <br /> CONTRACTOR NAME: ���J � <br /> CONTRACTOR ADDRESS: srReEr <br /> C�Ty STATE ZIP <br /> CONTRACTOR PHONE: � �— CON7RACTOR EMAIL: <br /> CONTRACTOR LIC.#{REQUIRED): � �IA CITY OF EVERETT BUSINESS LIC.#(REQUIRED):� <br /> PRIMARY CONTACT: ❑OWNER .�,CONTRACTQR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: l..��1.1 g�,,,. � ��.- <br /> L(�f''.Q,� �� CONTAGT ENIAIL• � <br /> AGREEMENT.•T hereby ca�tity that J have read and examined fhis appfication and know the same to be true and co ecL AI!provisions of laws and ordinances governing this <br /> type of wotk wilt ke completed whether specifred herein ornot. The granting of a permit does naf presume to grve authprity to violafe or cancel the provisions of any other state or <br /> locai law regulating consfruction or the performance of constructio». That I am authorized by fhe owner of this property fa perform the work for which appNcatian is made and/ <br /> comply with the Sfate Contractors Law 18.27 RCW and 296.200 WAC. <br /> . Cify of Everett OHiciat Use Only <br /> FE E <br /> �, �U 5o DO. <br /> PERMIT# <br /> ��� ��.-� �:��..�� �����'� E I �.�D�� Q�l� <br /> i3wner/Authorized Agent Signature Date (Revised 10/12/20i5) <br />
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