2612 E GRAND AVE 2018-05-29 - Laserfiche WebLink

'IP' ELECTRICAL PERMIT APPLLATON CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS; `IZ FFSr GRAWC) Ave- eV '"e vJ 9$2-o Z BUILDING. (if residential,new construction, remodel,or addition) SF BUILDING TYPE:X.SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-it OF UNITS, 0 COMMERCIAL USE OF BUILDING: !CAI,APPI.ISATION INFORMATION CONTRACT PRICE OF WORK. $ NUMBER OF DEVICES Of low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#`if a,m Iicabte DESCRIPTION OF WORK: ... . . al4eR 1 CI Acu if- F,^„• , YYtini ► it- } -eaj- 'CONTACT - OWNER NAME: TENANT NAME(ItCPtotrffilaIa : MINER MAILING ADDRESS: STREET Z(p t 2- a Si Gy-cLocl A ,,fi�rr //wr�,�+�+ Qo CITY L e E STATE Y�' LIP `I a 2,0 I OWNER PHONE: 425 rt(PO 1 OWNER:EMAIIM: -CONTRACTOR,NAME:., , , l� CONTRACTOR ADDRESS, STREET k -al , " ' CIN .E l._.e(W a STATE k../...6 ZIP CONTRACTOR PHONE: : (--)575 CONTRACTOR EMAIL',, • r CONTRACTOR LIC�, (I1uIRED).: i' i . ) CR.OF EVERETT BUSINESS LIC,*REQUIRED ' 9 �� . _. . PRIMARY CONTACT: 0 OWNER 'CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME:; CONTACT PHONE CONTACT EMAIL: " irriattiii ' '$ . kin AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and=.s =aces 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 298.200 WAC. City of Everett Official Use Only FEE " PERMIT# -- Y5 Owner/Authorized Agent Signature 9 9 Date (Revised 10/12/2015)