619 93RD ST SW 2018-04-05 - Laserfiche WebLink

AP ELECTRICAL PERMIT PLICATION I�►�� y- 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 CTtITE INFORMATION PROJECT ADDRESS: q q 3r4 e.,4 SUtl W A 7820q BUILDING AREA(if residential new construction,remodel,or addition) /> .2-0 0 SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: sinsie ho j�'ie - ( 04 J ELECTRICAL APPLICATION.INFOR�V ATiON` CONTRACT PRICE OF WORK: $ j , 2-0 da NUMBER OF DEVICES(if low voltage): z O o y FIRE ALARM? 0 YESLir NO ASSOCIATED BUILDING PERMIT#(if applicable): (J a Vie, DESCRIPTION OF WORK: ef(a Ce U) POL.fief a ild IA/ ply CONTACT INFORMATION OWNER NAME: Tulsa 13U-+-<fic(r i TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET S a.vvt C a 5 abo vG - CITY STATE ZIP OWNER PHONE: H OWNER EMAIL: CONTRACTOR NAME: et-(-Z Electric CONTRACTOR ADDRESS: STREET '75-7 1 16t.-.1:2. S freet 5®GiL14) /� Q CITY Taco,n4 STATE G;A ZIP q L' - CONTRACTOR PHONE: (206) 1 LI 6?8 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): jE E*Q Q 3 K 1 CITY OF EVERETT BUSINESS LIC.#(REQUIR:I): —`3(-1 PRIMARY CONTACT: 0 OWNER tgICONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ,/ CONTACT PHONE: ( qqq 6 ) -LI6 b%g o,) h (� Chor) EMAIL: 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 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# x/ - E 1%02 — 022 Owner/Authorized Agent Signature Date (Revised 9/23/2016)