11030 EVERGREEN WAY 2018-05-29 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 4/677 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 1 i 3 c) .vim& ^t W47 X82 a7 BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED- 0 DUPLEX MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING:(Lv g 1-100c LECTRICAL PPLICATION INFORMATION CONTRACT PRICE OF WORK* NUMBER OF DEVICES (if low o age): FIRE ALARM? 0 YES XNO ASSOCIATED BUILDING PER IT#(if appli -•le): DESCRIPTION OF WORK: it 1-4kit f 1 )L i v,22-C co C../91) vJ 1/V /v E'v AND lAiotnan/ '.i isi/Z. r c. N,L vv6 vnifw 1 /L5 1)1', ti) C INV&I-1ES k;VIC/vO,NG G X!S r/N V L.1 6 rH r C-1 R CA.)/ CONTACT INFORMATION OWNER NAME: C 4 rzi et-0 t 4P 4/2-r/''/- 1/T ''°w'ef TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET //0,70 fve.4- V/V WA,, (jir CITY //\N4, STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: j/)f/j✓j Et-6 !1. CONTRACTOR ADDRESS: STREET Zo 3 t'6 /S 714. A:-- 4/67 Q 515/4O 1 Ltiv CITY 1Wr,o4 STATE 6 Ts''' /�4i$S ZIP CONTRACTOR PHONE: a of S75 b 6 3-7 CONTRACTOR EMAIL: 43 ,,(,y\_ , mM CONTRACTOR LIC.#(REQUIRED):V(v IT"!tL 1 I 41 L 0 CITY OF EVERETT BUSINESS LIC. (REQUIRED): LkO Z PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR (c-'OTHER(Please Specify)/)14141TG4/44t , CONTACT NAME: CONTACT PHONE: 1-K2/-5_ 2y y ?'S Z N/6 CONTACT EMAIL: AGREEMENT.-!hereby certify that!have read and examined this application and know the same to be true and correct. All provisions of laws 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 cancel the provisions of any other state or local law 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only /o// E� /7 PERMIT� 0 er/Authorized Agent Signature Date (Revised 9/23/2016)