801 75TH ST SE 2018-04-25 - Laserfiche WebLink

�ECTRfCAL PERMIT A�ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETf,WA 98201 (P)�25-257-8810 j FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.govlpermits : PRl�,IECT S1TE t�IFQttMA"�"1QN.` - . _. PROJECT AQDRESS: ' � '� � , � BUILDING AREA{if residential,new struction,remodei,or addition} ' � SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR ATfACHED ❑DUPLEX MULTt-FAMILY-#OF UNITS: ❑COMMERCtAI USE OF BUILDING: � y ELECTRfCAL APPLiCAT10N,INFORMATION ` CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES if law voita e : FIRE ALARM? ❑YES NO ASSOCIATED BWLDING PERMIT# if a licabie : DESCRIPTION OF WORK: 3�• �L$(°A: . � -� -� � � < �acl � �C�O � ' �� �Wl`� h} � � co�r�►�r��FaR��r��►N OWNER NAME: � � Q,. TENANT NAME if Commercj,al}: OWNER MAILING ADDRESS: s�eer Q ST � O � CiTv 5rarE zaP Q OWNER PHONE: � Q, OWNER fMA1L: _. CONTRACTOR NAME: \ , _' ` CONTRACTOR ADDRESS: srne� \ �, �.��1r� ''� � cir� srA� rP�, CONTRACTOR PHONE: �� CONTRACTOR EMAIL: • � � � 1 CONTRACTOR UC.#(REQUIRED): � `p CITY OF BUSINESS LIC.#(REQUIRED): _ _. _ _ _ ._ _ _. _ , PRIMARY CONTACT: ❑OWNER -ONTRAGTOR ❑OTHER(Please Specify} CONTACT NAME: CONTAGT PNONE: {�� � CONTACT EMAiI.: AGREEMEIVT.•7 hereby ce at/have read and examined this application and know the same to be true and conect A!/provisions of laws and�nances goveming this type of work wiN be compieted whether spea�d herein or aot 7he granGng of a pem�it does not presume to gi+re authority to viofate or cancel the pravislons oiany other state or locaf law regulating consWction or the perfomrance of consducfio2 That I am authorized by the owner of this property to perform the work for which appiicaSon is made and! compty with the State Gonfractors Law 18.27 RCW and 296.200 WAC City of Everett Official Use Onfy �..�.�� FEE � �� . PERMIT# a �-� E � �o`� ' I Z Owner/ t n Signature ate (Revised 10/122015)