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

�ECTRtCAL PERMlT A�ICATIQN CITY OF EVERETT PERMIT SERVtCES 3204 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gov� www.everettwa.gov/permits _ PR8-�ECT St'I��iFORNt�'1`lON ; _ PROJECT ADDRESS: '� �1c� �� n �' BUILDING AREA(if residential,new nstruction,remodel,or addition) ` 1 SF BUILDING TYPE: O SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ` V ELECTI�ICAC APPLICATION 1NFORMpTION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES if low volta e : FIRE ALARM? ❑YES NO ASSOCIATED BUtLDING PERMIT# if a ticable : —_. _ DESCRIPTION QF.WORK: 3'�• ��.Pj(`,� �, . -� • � _ �V $ �� ` �� `� �} � r C�NTA�T iN�'QRMATIQN , OWNER NAME: U�� 2. 1� TENANT NAME(lf Commers�bal): _ . R. OWNER MAILING ADDRESS: s-rReer O� ST � � ciTv STATE ziP � OWNER PHONE: � Q` OWNER EMAIL: _ _ _ _ � , CONTRACTOR NAME; � ( CONTRACTOR ADDRESS: STREET ` �, �.��1r� '"� � . cro sTa� z�P CONTRACTOR PHONE: �� CONTRACTOR EMAtL: • � � ' t GONTRACTOR LIC.#{REQUIRED): � ClTY OF E BUSINESS LIC.#(REQUIREDj:' _ _ PRIMARY GONTACT: ❑OWNER �ONTRACTOR O OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Q`` � r GQNTACT EMAFL: AGREEMENT.•T hereby ce at 1 have read and examined this appl'�ation and know the same to be true and correcL All provisiorts of/aws and ordinances govemi�g this type of work wBl be comptefeat whether specified herein or not The granSeg of a pernrit does not presume to give authority fo vio/afe or cancel the provisions of any other state or loca!law regula6ng construction or the peiformance of constroc6on. Thaf!am authorized by the owner of this properly to perform the work for which ap�ication is made and 1 comply wi#h fhe State Contractors Law 18.27 RCW and 296.200 WAC. CFty of Eve�H Official Use Onty FEE � �'� ,� PERMIT# a �-� E � l�o�� 1 �'� Owner/ t n Signature Date (Revised f0/12l2015)