1701 121ST ST SE 2018-04-25 - Laserfiche WebLink

_E�TRICAL PERMIT AF ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 —, (P)425-257-8810 � FAX 425-257-8857 � (E)everetteps@everettwa.gou � www.everettwa.gov/permits - - _<. ,: . .. �, � _ "_ .:' PRbJECT SITE INFORMATION` PROJECT ADDRESS: � 7O� I o� S~ S l E �I GG BUILDING AREA(if residenfial, new construction, remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION 1N�FORMATION , , CONTRA.CT PRICE OF WORK:$ , Q NUMBER OF DEVICES (if low voltage): ' FIRE ALARM? ❑YES ,�V4 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: �L.f} �DG�S n1 � � N 2rJ ��t� l /a , ,, .. . .; . _ _ CONTACT INFORMATION , NER NAME: ,�EL-,s�'oHO�t/$}} ��p�r�(r.S TENANT NAME(If Commercial): �t 5 OWNER MAILING ADDRESS: srReer oZ TNTEYGNA'IZGL�I�rC� L • CITY QS'�/�J STATE � ZIP Q Z`J OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ��-,I�( f� ,,t) �J-'rJrJ CONTRACTOR ADDRESS: sTReeT 1 I J �'t^Q . W • CITY �N STATE ZIP (�„�j CONTRACTOR PHONE: � ��7-rj l�; CONTRACTOR EMAIL: � �wtJ � 7V1� .�-� CONTRACTOR LIC.#(REQUIRED��/l��' I�" � CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ❑ OWNER �CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: !�'�f_-Z�j��Cl� � CONTACT EMAIL: '� {`� .�N 1 I��N�� AGREEMENT.•T hereby cerfify that!have read and examined this application and k�ow the sama fo be true and correct. All provisions of laws and ordinances goveming this fype of work will be completed whether specified herein ornot_ The granfing of a permif does not presume to give authority to violafe or cancel the provisions of any other sfate or /ocaf law regulating construction orthe performance of construction. That 1 am authorized by the owner of this property to perform the work for which applicafion is made and 1 comply with the State Contractors Law 98.27 RCW and 296.200 WAC. Cify of Everett O�ciai Use Only FEE ��e�� /''y� V"/ � d PERMIT# � z�� E ��O�-l�5 Owner Auth ized Agent Signature Date (Revised 10/92/2015)