7510 OLYMPIC DR 2018-05-30 - Laserfiche WebLink

,11P, 7—_,--4 ELECTRICAL PERMITAPPLICATION -_; CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.govI www.everettwa.gov/permits PROJECT SITE INFORMATION` PROJECT ADDRESS: 75 16 0 f l #I( II) V BUILDING AREA(if residential,new constructio ,remodel, or addition) SF - BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: L.t V1 n t _. ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 57100 NUMBER OF DEVICES(if low voltage):, FIRE ALARM? lirYES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTIONpOF WORK: C P\ tATI(/l.((/ly 3 C t rt.i c �r A [-2,ert4 roc(i1 /'I dQ fi�'l f� 1 1 6 l '/ Adr1 l j/I D/ rZ h1 e kr. t�15'ow L `.c--D e - __- - CONTACT INFORMATION OWNER NAME: / dot, h a.. I (A4/;lie,' TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7� 10 © CY[rvlp%G., 0v CITY j V `f t / STATE 1„/k ZIP / g2 03 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: C.0,/ 1 rw , .le/C.4-r(G CONTRACTOR ADDRESS: STREET 59 oil 7_244-frt' c-i- c(,,/ p CITY /1 0(A lel le TV'� P STATE �[,/N- ZIP `�/ # CONTRACTOR PHONE: 2 6 ,9 -7S CONTRACTOR EMAIL: l-f pv L1,, Gtok crf-.,,- ,e- — CONTRACTOR LIC,#(REQUIRED) C (/ir I a g9S r1/ CITY OF EVERETT BUSINESS LIC #(REQ RED): ---1 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: '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 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 lam 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 ......_ • r / PERMIT# �O r�, / L4 / _I; E Owner/Authorized Agent Sig ature Date (Revised 10/12/2015)