5501 COLBY AVE 2018-05-01 - Laserfiche WebLink

�LECTRICAL PERMI°T APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E) everetteps@e�erettwa.gov � www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ��9l 0 /,�12�G BUILDING AREA(if residential, new construction,remodel,or addition) �� SF �v�-- BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED- ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: ritf0�� 5(�U/� S��O ELECTRICAL APPLICATION INFORMATION` CONTRACT PRICE OF WORK:$ ,30U. NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES [�NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: l�p ou1b2 aN� u0 ��L-LL W�R� Sd¢� �2 Ll6f�T-S �- �1...�-�cc� o u7'u� CONTACT INFORMATION OWNER NAME: C��L /n+rf7�-]�r'1� TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReEr SS O j COC-�Q �/ �}-v� CIiY �� 1 � STATE � ZIP %�� OWNER PHONE: ��"oZ.�3—S 17� OWNER EMAIL: GU2IZ�/�l a � (�M/�'dL , CD✓t/\. _ _ CONTRACTOR NAME: �Lr CONTRACTOR ADDRESS: sTREeT S I��'�'L /3'� I�'�O�I Z CIIY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): , .:. . .. . ,. , ,..:.... _ , -. ._...: . , , . . _ . , . . .. . PRIMARY CONTACT: �OWNER ❑CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: y� a ��-- S'�"�'7 �'/'31'2C.r �"/Z?�vV CONTACT EMAIL: L'014,/'�5�.�/D � Cs�'1'��1 • D,.Y� AGREEMENT.�l hereby certify tbat l have read and examined this applicafion and know the same to be true and correct. AI!provisions of laws and ordinances goveming this type of work will be completed whether specified herein or not. The granting of a permif does not presume to give authority to violate or cancel the provisions of any ofher state or Iocal law regulating construction or the performance of construction. Thaf l am suthorized by the owner of this property to perform the work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett O�ciaf Use Only `, PERMIT# �-�v V /�.I //�� 7 E � �11 D r L �� Owner/Authorized Agent Signature Date (Revised 9/23/2016)