808 LAUREL DR 2018-05-22 - 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 PROJECT SITE INFORMATION PROJECT ADDRESS: $OS LaUf@I Df BUILDING AREA(if residential, new construction, remodel, or addition) 1600 SF BUILDING TYPE: � SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL usE oF Bui��iNc: Residential ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (if low voltage): FIRE ALARM? ❑YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): �ESCRIPTION oF WORK: Replace knob and tube wiring in house. CONTACT INFORMATION OWNER NAME: EfIC SCh211b2fg TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTReeT 808 Laurel Dr �,n Everett STATE WA Z,P 98201 OWNER PHONE: 206-856-6179 OWNER EMAIL: ZSCh211@SpU.edU CONTRACTOR NAME: D W l�f � CONTRACTOR ADDRESS: srReer CITY 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: 2�6-$56-6�7Q Eric Schellberg CONTACT EMAIL:ZSCh211 C�(SpU.2dU AGREEMENT:I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of/aws and ordinances governing this type of work will be comp/eted 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 construction or the performance of construction. That/am authorized by the owner of this property to pertorm the work for which application is made and I comp/y with the State Contractors Law 18.27 RCW and 296.200 W,4C. City of Everett Official Use Only PERMIT# �, � 1(� (� - �b E �(�c�- b7�O Owner/Authorized Agen ' nature Date (Revised 9/23/2016)