2413 HILLSIDE LN 2018-05-29 - 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 PROJE�T StTE INFORMATION PROJECT ADDRESS: Z y �3 I � �� . G er C O �� BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI-FAMILY-#OF UNITS: ❑ COMMERCIAL USE OF BUILDING: CT CAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: NUMBER OF DEVICES if low olta e : FIRE ALARM? ❑YES NO ASSOCIATED BUILDING PERMIT# if a licable : DESCRIPTION OF WORK: �1'�S'�G.�� $�0.r v S �f. CONTACT INFORMATION OWNER NAME: l�rC � 0./b0.f � ,1,JA�/�� TENANT NAME(If Commercial}: OWNER MAILING ADDRESS: srREET Zy " Ln, CITY �v eY C� STATE �f�1 ZIP q 820 OWNER PHONE: 2 —Z,3 I ' Z OWNER EMAIL: Glr,b 0./1 d Y (�'� /'� • CONTRACTOR NAME: G�S-}e(P1 CONTRACTOR ADDRESS: s�ueer � CITY l,�' STATE ZIP I (�G..L.� CONTRACTOR PHONE: 3�0�' 7 y�p— CONTRACTOR EMAIL: �,{�Q/ WCS'�f�1 ari nc � � CONTRACTOR LIC.#(REQUIRED): wE.ST ES� S� Z D� CITY OF EVERETT BUSINESS LIC.#(REQUIRE : V �� PRIMARY CONTACT: ❑OWNER �CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: �(p�_'7(1'�D� O S Ch� V ' ,Bea,�. ' CONTACT EMAIL: �, Y I �Qf 11 0�0.r 1 C. C 0� AGREEMENT:T hereby certify that I have read and examined[his application and know the same to be true and correct. Al1 provisions of laws and ordinances goveming this type o(work wi(1 be completed whether specified herein or not. The granting of a permit does not presume fo give authority to violate or cancel the provisions of any othe�state o� focal faw regulating construction or the performance of construction. That I am authorized by the owner of this property to perform the work for which application is made and 1 compty wifh the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE `J � PERMIT# ' �- � 6 � �� E l��C ---i� � OwnerlAuthorized Agent Signature Date (Revrsed 10/12/2015)