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4925 OCEAN AVE 2018-04-05
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4925 OCEAN AVE 2018-04-05
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Last modified
4/5/2018 9:16:41 AM
Creation date
4/5/2018 9:16:36 AM
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Address Document
Street Name
OCEAN AVE
Street Number
4925
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4'7 !LECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 4 /,Rs' V C c a.rt /4i/se_- <br /> BUILDING AREA(if residential, new construction, remodel, or addition) ,YeR 0 0 SF <br /> BUILDING TYPE: 0 SFR-DETACHED -k(SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ //a C 0 a <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES k) NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Lits r r, 507 0 0 (S? 'T NL°L✓ h4,,,r, <br /> CONTACT.INFORMATION <br /> OWNER NAME: jc�'a y- )L-7 UTENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET ss <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: A../e) -') rrr^)7 I 'A.'IL t ;z,6//G'7y-.1 -�oa <br /> CONTRACTOR ADDRESS: STREET //Se?<7 9 r3 "XIV <br /> CITY Ars/yJ!". 6 J) STATE 't",(.047 ZIP 9 z_z,,J <br /> CONTRACTOR PHONE: 92e3.7i9 02'90 CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): ,1 Ja j21 1 2' D 9 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): c73 ?''c' <br /> PRIMARY CONTACT: 5a OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 90 C.33c, $'3q0 <br /> c i `t CONTACT EMAIL: <br /> AGREEMENT:I 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMI(T_# <br /> 7 7�/‘ E 'VLc 1 <br /> Own uthorized Agent Signature atS to (Revised 9/23/2016) <br />
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