6807 EVERGREEN WAY 2018-05-17 - Laserfiche WebLink

I =CTRICAL PERMIT APF CAT14N CI7Y OF EVERETT PERMIT SERVICES 3240 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 � FAX 425-257-8857 � (E}everetteps@everettwa.gov � www.everettwa.gov/permits i ' PROJECT SITE.INFORMATION PROJECT ADDRESS: � ^� "�(f� � BUILDING AREA{if resfdentlal,new constructl n, remodel,or addition) SF BUILDING TYPE: C7 SFR-DETACHED �SFR-ATTACHED ❑ DUPL�X ❑MUL71-FAMILY-#OF UNITS: COfvSMERCIAL USE OF BUILDING: � � P c� ELEGTRICAL APPLICATION INFORMATION ` CONTRACT PRICE OF WC?RK: $ �,� �G� NUMBER OF DEVICES {if low voltage : FIRE ALARM7 ❑YES fV0 ASSOCIATED BUELDIWG PERMIT# if a licable : DESCRIPTION OF WORK: cS�SLOY�� t � r�. td y� 1,��'�� O�� I CONTACT.INFORMATION bWNER NAME: TENANT NAME(If Commercial : (ti OWNER MAILING ADDRESS: sTReeT �O � �,L� �, � 1�,� � cm� r �'� srnrE V v ziP � OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: � COIVTRACTOR ADDRESS: srReer ' i VS� L� ^� CITY �.�✓►� STATE V `� � ` ZIP �� CONTRACTOR PHONE: p�Z'��j-rj � CONTRACTOR EMAII.; (�,(,�,}'�• ' / �jC -Gc,:vv► �CONTRACTOR LIC.#(REDUIRED}: �� CITY OF EVERETT BUSINES3 L.IC.#(REQUIRED):{� , � 7 PRIMARY CONTACT: ❑OWNER CONTRACTOR �OTHER(Please Specify) CONTACT NAME; CONTACT PHONE: ��J' - �'7'�•�� ��'�J Vl �C.� CONTACT EMAIL• � '�. � � l AGREEMENT:!hereby certify thaf 1 have read end examinad thrs applrcatron and know the same to be true and correct. A!I provislons of laws and ordrnances governing this type of work w�Y!be complefed whefher specifred herern o�not. The granting of a permit does not presume to glvB authority to violate or cance!ths provlslorts oJany ofher sfate or loca�law regulet�ng consfructlon or fhe pe�fomrance of constructlpn. That!am authorrzed by the owner of this property to perform fhe work for which applJcation Is made and/ comply wifh the State Conbactors Law 18,27 RCW and 296.200 WAC. G�,w� �. �� g(��l-Z�� � Crty of Everett Of(icial Use Only � PERMIT# �,z�, � EI'�o�b � l5 OwnerlAut orized Agent Slgnatura Date (Revised 9/23/2016)