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1321 GRAND AVE 2018-07-24
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1321 GRAND AVE 2018-07-24
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Last modified
7/24/2018 3:25:50 PM
Creation date
7/24/2018 3:25:49 PM
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Address Document
Street Name
GRAND AVE
Street Number
1321
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4rerr ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: ,./.?2/ Gid-.y�,0 �-rl✓d Aj i7"-- — 92.2.0/ <br /> BUILDING AREA(if residential, new construction,remodel,or addition) $40.0 SF Gid .sfL <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 6,,� f‘ <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES ZJ4 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: <br /> CONTACT INFORMATION <br /> OWNER NAME: 2i�� Z'$/9 TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET /72 djr.,f.4.,0 <br /> CITY L.CE/� STATE lit/n zIP g#19.4Q/ <br /> OWNERPHONE: 'r 'o lJ 9 C..Z✓G OWNER EMAIL: 9J ' <br /> . ,r«.� iie7�Yt../,f�L� <br /> CONTRACTOR NAME: LOJG <br /> CONTRACTOR ADDRESS: STREET AZ� ,f7 72;7-i .CAC <br /> g <br /> CITY Z.4.4 �7�l/f��/ STATE ‘,..041051 ZIP ffG ZS- <br /> CONTRACTOR PHONE: yzS 7 793 - Ries CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED) 3 77/ <br /> PRIMARY CONTACT: In OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> 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 <br /> 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 <br /> local law regulating construction or the performance of construction. That l am authorized by the owner of this properly to perform the work for which application is made and I <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> ibo °% <br /> PERMIT# <br /> �. 7 E b61( <br /> Ow uthorized •gent Signature Date (Revised 10/12/2015) <br />
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