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850 OLYMPIC BLVD 2018-04-13
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850 OLYMPIC BLVD 2018-04-13
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Last modified
4/13/2018 1:09:57 PM
Creation date
4/13/2018 1:09:56 PM
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Address Document
Street Name
OLYMPIC BLVD
Street Number
850
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V.ECTRICAL PERMIT AFLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION j <br /> PROJECT ADDRESS: 8 so �uere)4 / ggple 3 <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL,APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3 5-0 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: RV- Ccwt.* 5O �,,,0 ago vok4 <br /> CONTACT INFORMATION. .: <br /> OWNER NAME: ?p 6 / 4`c_ L&& TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET (� <br /> CITY C V e,re> 4 STATE W✓A ZIP `k?..2,3 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME: TN- O to <br /> CONTRACTOR ADDRESS: STREET Ill( t 6 `-� S4 S ("f ' ./ �] <br /> CITY <br /> C.-.7; V a^r' ISTATE W A ZIP if do, <br /> CONTRACTOR PHONE: p2Oc3-1`(O.-C CONTRACTOR EMAIL: geU S�a,1 6:: (ow) C�s�,Itele f <br /> CONTRACTOR LIC.#(REQUIRED): �tV J— `)O\3O CITY OF EVERETT BUSINESS LIC.#(REQUIRED): d`/ 18 <br /> PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: #443 — - Cfit <br /> ` <br /> �,r V y)6\( CONTACT EMAIL: <br /> AGREEMENT:T 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 <br /> 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 <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 /> FEE <br /> 54 / PERMIT# <br /> &Aid -�K'l� E 1 ,Q01 ' 1, c)L <br /> ner/Autho '�* t Signature Date (Revised 10/12/2015) <br />
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