10023 MONTANA RD 2018-05-30 - Laserfiche WebLink

/Mt_ ELECTRICAL PERMIT APPLICATION Niteigjj CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E) everetteps@everettwa.gov I www.everettwa.govipermits PROJECT SITE INFORMATION IECT ADDRESS: i I M o r 7 'CV G DING AREA(if residential, new construction, remodel, or addition) SF DING TYPE: PR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS._ 0 COMMERCIAL OF BUILDING: V..— i (31`iI- IterL.- ELECTRICAL APPLICATION INFORMATION IITRACT PRICE OF WORK: $ 5 00 ABER OF DEVICES (if low voltage): ALARM? ❑YES ❑ NO >OCIATED BUILDING PERMIT#(if applicable): >CRIPTION OF WORK: SP L4 U Y (--1 ) YYl � ,q�,� CONTACT INFORMATION -� 1ER NAME: S • ' nit D 1 fit'r\0 TENANT NAME(It Commerctalj: MER MAILING ADDRESS: STREET 00 :3 I\JnT" Co, C-- /- Cr STATE leitijer aPci ✓ NER PHONES 1 1 51! .127\ 1 _OWNER EMAIL:f \ �S C7 WI n OA'rrtiDD•L-JYy) TRACTOR NAME:'\ } nyNP7 -iC,- JTRACTOR ADDRESS: sTR=_a- 74t1/ - EThf .-¢ S& STATE IN" zu. EDaVfV JTRACTOR PHONE: D9_CONTRACTOR EMAIL:7\ prY\ihe,,pNE:(4..1 SI-Den •/G� )�t, iTRACTOR LIC.#(REQUIRED):C t �'' 1--?f -DG'1 a VI, CITY OF EVERETT BUSINESS UC.#(REOUiRED):C?5 --'1✓l 4 MARY CONTACT: ❑OWNER 7. •NTRACTOR 0 OTHER .Please Specify) (TACT NAME: CONTACT PHONE: / - - /�-�^�O ^ �(�-��^� / ke M C r 1 W On CONTACT EMAIL: + YY'\I f l'1,_7 ►4ye,i�L r V tom 'EEMENT I hereby certify that I have reed end examined this sppticatrun end know the senor to be true and con,c1 A8 pravrsA ns nr Jews and attinenor s paean ing thiV type orfs wd be completed whether specified herein or not The granting of a permit does not presume to give authority to Opiate or cancel the prevision o/any otter stab ce law regulating oonshuctson or the performance of construction That I am authorized by the owner of this property to perform the wok for which apprentice pt made end t >ly with the State Contractors Law 18 27 RC W end 296 200 WAC cZY}j\ City a Everett otlkaar UseOnly PERMIT# E1 ,?3,0(-4, 019