805 112TH ST SE 2018-04-25 - 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 � 4��`� } � � � � : PROJECT SIT�IN�OR'�MA'TION "� �f � � - ° � � >..... � �.. . __... .�,. �.. �; � ��. �� �� ;.. ��; <� �. w. _� ...... ��. t. .. ,., . . ,...,. a. ..,, .u. k... �... , PROJECT ADDRESS: � � � BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ��S :. , `: ELECTRICAL APPLICATION INFORMATION ` CONTRACT PRICE OF WORK:$ (�p QQ _ Q C� NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: (�d t7��L �L� ��.(9 p�I�� �A� LC t-E- 'D�t bc�� r CONTAGT 7NFORMATION � -�. � � � �. � OWNER NAME: l -�j L,L.��, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: srReeT O� � 2C�� CITY STATE ' ZIP D � OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: �� `� L CONTRACTOR ADDRESS: sTReer 2 �� � r�`l' 1 �Clll' STATE �- ZIP �� CONTRACTOR PHONE: b �?`7 CONTRACTOR EMAIL: �/�M� 1�]V.� �L CONTRACTOR LIC.#(REQUIRED): �� CITY OF EVERETT BUSINESS LIC.#(RE IRED): Q�D(p(� PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) . CONTACT NAME: CONTACT PHONE: �j�� , ?? � �(1J`C'�-S C�N 1� �1� CONTACT EMAIL: An.�q$j � �L�L��L IC • C f3"' � AGREEMENT.�I hereby certify that 1 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 construcfion or the pertormance of construction. That I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 W,4C. City of Everett Official Use Only PERMIT# 1D �� E �� o �- a� � Owner/Auth ri ed Agent Signature D te (Revised 9/23/2016)