4428 RIDGEMONT DR 2018-06-27 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 (E)everetteps@everettwa.gov I www.everettwa.gov/permits Ppb:! ICT qg INFORMA11OIh[ PROJECT ADDRESS: 4442.g 0%01 r 1,00 Cri?,020 BUILDING AREA(if residential,new construction,remodel,or: ttti n) St= BUILDING TYPE:; SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: 14,11 CONTRACT PRICE OF WORK: I .cO NUMBER OF DEVICES(If lowvolta ! ): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#, it a.;®IIcable : DESCRIPTION OF WORK: n. ^. OWNER NAME: Ki ver5e, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET A.S.A.S 5CITY STATE: ZIP OWNER•PHONE: . OWNER EMAIL. CONTRACTOR NAME: CIA 14,0.401;19 CONTRACTOR ADDRESS: STREET ^�n� 1 I laroaci ..::; ....:.: ciTr ya:r�`-' •C� sraTE SAI zie �$2Q 1,, CONTRACTOR PHONE: qp5-asq 095b CONTRACTOR EMAIL: k {(; 'CO VP CONTRACTOR LIC414PEOVIRED);CrtiheikeYk ldCITY OF EVERETT BUSINESS LIC.#i , ctUIRli ). PRIMA'CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Las 959 DITDO CONTACT EMAIL: C P,h! • tettQ`t•i •cabin AGREEMENT:I 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 PERMIT# a 10.15 .t. E. Owner/Authorizer!Agent Signature Date (Revised 9/3/2016