2211 W CASINO RD 2018-04-20 - Laserfiche WebLink

ELECTRICAL PERMiT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 ( FAX 425-257-8857 � (E)everetteps@everettwa.gov � www.everettwa.gov/permits _ .. ..: ` PROJECT SITE INFORMATION '` PROJECTADDRESS: 2211 W. CASINO RD, EVERETT WA 98204 BU[LDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTt-FAMILY-#OF UNITS: �COMMERCIAL USE OF BUILDING: . .::. ........ :.:....... .... _ ...., _.,.:............., ,........,. ' ELECTRICAL AP.PLICATION INFORMATION ` ' CONTRACT PRICE OF WORK: � 1100. NUMBER OF DEVICES if law voltage : � FIRE ALARM? ❑YES E�J NO ASSOCIATED BUILDING PERMIT#(if applicable : DESCRIPTION OF WORK: NEW POLE MOUNTED CABLE BOX 120V 20AMP SERVlCE�� `�!�� CONTACT INFORMATION OWNER NAME:CABLECOM TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREEr 8602 MATLBY RD �„Y WOODINVILLE STA,�WA Z,P 98072 OWNER PHONE: 360-66$-1300 OWNER EMAIL: CONTRACTOR NAME: AHEARN ELECTRIC LLC CONTRACTOR ADDRESS: S-�E�4843 AUTO CENTER WAY �,TM BREMERTON STA�WA Z,P 98312 CONTRACTOR PHONE: 36O-3T3-"I 9OO CONTRACTpR EMAIL: KIMBERLY@AHEARNELECTRIC.NET CONTRACTOR LIC.#(REQUIRED); AHEARE"I OOHPA CITY OF EVERETT BUSlNESS LIC y* ="�� PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR ❑OTHER(Please Specifyj —� � ` �—'— � CONTACT NAME: CONTACT PHONE: 360-265-8769 ERIK TANGEN coNracT eMA��:KIMBERLY@AHEARNELECTRIC.NET AGREEMENT.•1 hereby certlfy that l have resd and examined fhis applicatlon and know the same to be true and correct Atl prov/sions of laws and ordinances governing this type of work w1ll be oompleted whether specffled hereln or not. The grenting of a permtt does not presume to glve authorify to vlolate or cancel fhe pro+dslons of any other state or local law regulaffng construction or the performance of constructlon..That!am authoHzed by the owner of thfs property to pertorm the work for whlch appUcaBon!s made and( comply wlth the State Contractors Law 18.27 RCW and 296.200 WAC. Clry of Everett OfBclal Use Only PERMIT# KIMBERLY WASHBURN 4/7/'17 E 17 D �f- d�� OwnerlAuthorized Agent Signature Date (Revised 9/23/2016)