615 80TH ST SW 2022-01-03 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT ADDRESS: (PIS' ®o'rO 6T .50 BUILDING AREA (if residential, new construction, remodel, or addition) $000 SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI -FAMILY - # OF UNITS: I$ COMMERCIAL USE OF BUILDING: Y` 00%>r-A C;T0& I NC, CONTRACT PRICE OF WORK: $ i T. NUMBER OF DEVICES if low voltage): Z$ FIRE ALARM? -'EI YES ❑ NO ASSOCIATED BUILDING PERMIT # if applicable): DESCRIPTION OF WORK: l AJ s?Ac-t_ /4 0024.55 Fl2i . ALAtZv--N OWNER NAME: nococ.K AAe-t L- SMELLS TENANT NAME (If Commercial): Qp L OWNER MAILING ADDRESS: STREET Lol S PSr-IT R sT St-) CITY 4-1/ 4JZ,, re: STATE ZIP (OWNER PHONE: IOWNER EMAIL: 1 CONTRACTOR NAME: 3 A. N F I Az4 A Q'o R 7 U—e--- CONTRACTOR ADDRESS: STREET PO SO -A 3-2 ! 1 CITY A G.T O STATE W A ZIP CONTRACTOR PHONE: ` 'Z'9 Z4LJ k4 CONTRACTOR EMAIL: sla-r-P @ fW N r-Ia:L -<WV'N CONTRACTOR LIC. #(REQUIRED): fNLHr-&q? = CITY OF EVERETT BUSINESS LIC. #(REQUIRED):ps�(o PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: Lj zs ZVq /4 SFR, CONTACT EMAIL: Siff (^— AUHLklI ltN 1: 1 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 specked 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/ 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 RC W and 296.200 WAC. City of Everett Official Use Only FEE�f t `\?—• �O PERMIT # E\ ---�<2-01-O Agent Signature Date (Revised 1011212015)