1832 MADISON ST 2018-07-18 - Laserfiche WebLink

!LECTRICAL PERMIT AFIOLICATION 'IA/ . CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov1 vwvw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: / ' 3 Z j ,4 cjsc, sT BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: E7 COMMERCIAL USE OF BUILDING: G_JLG� rGl� ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CONTACT:INFORMATION. • OWNER NAME: Mao C p/n/�-if.C..�� l=jr,„,r.TTENANT NAME(If Commercial): __5-c OWNER MAILING ADDRESS: STREET / Z,Z 1,2 CITY !/`e t' / STATE I ZIP ,, '3 OWNER PHONE: L/.Z--S- JJ ? 22 7d OWNER EMAIL: CONTRACTOR NAME: id,S CONTRACTOR ADDRESS: STREET ?c/4' 7d CITY 6-74/-e-,,0-e.,64. STATE LA4i- ZIP 2,, � CONTRACTOR PHONE: L12 c )Sc) CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):pSori4 AL2,442 CITY OF EVERETT BUSINESS LIC.CREQUIIRED):ey igy? PRIMARY CONTACT: 0 OWNER Ig-CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 47.4.5- 7,0 -eCtet. CONTACT EMAIL: _5""ce, 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 tam 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# EY D DSC Owner/,;."":rized Agent Signature Date (Revised 10/12/2015)