1011 NORTH PARK DR 2018-07-11 - Laserfiche WebLink

EMCTRICAL PERMIT APPATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 j(E) everetteps@everettwa.gov I www.everettwa.govipermits PROJECT RITE INFORMATION .... MATQN PROJECT ADDRESS: '( _1 Q0. - _ BUILDING AREA(if residential, new construction,remodel,or addition) SF .. BUILDING TYPE FR DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: • CONTRACT PRICE OF WORK: $ „op, ,•« NUMBER OF DEVICES .if low voltase FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if appficable). DESCRIPTION OF WORK: • -�-. � CONTAE T11/000MATI OWNER NAME: CTENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET t If .4 e'. a tee: CITv s . • _ .. OWNER PHONE:.LA .24,Segvz OWNER EMAIL; CONTRACTOR NAME: Ali Is " IB Ct NTR CTORADDRESS STREET ,..4 co Tit -, r,. STATE �� ZIP CONTRACTOR PHONE, ai { �i �1 CONTRACTOR EMAIL:r - . .! � .� CONTRACTOR LIC #(REQUIRED 6 e '�J • i y� CITY OF EVERETT BUSINESS I„IC �` C�t11RED}: PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE, CONTACT EMAIL a, _ at 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 a+ - a 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 l 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 FEE PERMIT# E l� 2 -19 Owner/Authorized Agent Signature Date (Revised 10/12/2015)