1717 COLBY AVE 2018-05-01 - Laserfiche WebLink

�LECT°RICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 j (E) everetteps@everettwa.gov� www.everettwa.gov/permits PROJECT SITE INFORMATION' PROJECT ADDRESS: �� G �w BUILDING AREA(if residential, new construction, remodei,or addition) SF BUILDING TYPE: FR-DETACHED ❑SFR-ATTACHED- ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: J�� r'-��u ,�C ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 7, OdZ> NUMBER OF DEVICES (if low voltage): 2� FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: t-ic,�+,�/l, L�' � .��t,v{,�.1'-� CONTACT INFORMATION OWNER NAME: W'�- �'p1n� -� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: s-rReeT CtTY STATE ZIP OWNER PHONE: -f{ZS �Z co��3 OWNER EMAIL: CONTRACTOR NAME: l�1'�I/� �(c1c-G �/� CONTRACTOR ADDRESS: sTReeT �-t.�µ,. /�- � CITY (�� STATE C�/ff'b ZIP ( js (.� CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): �E�� -l(t QC-- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONT O NER ❑CONTRAGTOR ❑OTHER(Please Specify) C`NTACT NAME: G��°�'�'` CONTACT PHONE: JG� f�2 (s��( � JG.9y'�'� IsL-d -; CONTACTEMAIL: ��Y�,��,z,�,�L,.��✓�� .��,� AGREEMENT.�1 hereby cerfify that 1 have read and examined this application and know the same to be true and correck AlI provisions of/aws 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 cancei the provisions of any other state or local law regulating construction or the performance of construction. That l am authorized by the owner of this property to perform the work for which application is made and l comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# --�=—___.-,–, - �� ,� � E � � r o _ Owner/Authorized Agent Signature Date (Revised 9/23/2016)