6602 BERKSHIRE DR 2018-09-06 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 10111;err 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E) everetteps@everettwa.gov l www.everettwa.gov/permits PROJECT SITE4tNE+DI ATIC1t+t PROJECT ADDRESS: tetC10 A K'shl BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: R-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: yo- ELEC`.I''RICAL'A"-4160(6,141, FORM ° JON CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES (If low voltage): FIRE ALARM? ❑YES ASSOCIATED BUILDING PERMIT#(if a_plicable): C ESCRIEIIDN QEWORK: _l _- atir ri OWNER NAME: Hai: .t.taox. TENANT NAME(If Commercial): _ OWNER MAILING ADDRESS: STREET I ftoo,, � 'L i"4+�I I(re r cr r !'•r�'f � P...l ., 57AIE J ZIP kg" OWNER PHONE: K7(0 ( .'t7 OWNER EMAIL: � 1' CONTRACTOR NAME: � -1 KO--a-Ti Cf CONTRACTOR ADDRESS: STREET �t I O°do(] p t )� ^s CITY STATE A JAI- ZIP C 2v ' CONTRACTOR PHONE: Los "I Q J T CONTRACTOR EMAIL: d ? i ckyi 4-tg ` CONTRACTORZIC.#(REtUJRED}: Yk� j {�- - , ,# _..-.._ ~-- --• � ►t7 f 4i CITY OF EVERETT BUSINESS LAC,.#(REQUIRED 11,x PRIMARY CONTACT: 0 OWNER r* CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 39 72,00.1(21e Ie CONTACT EMAIL: deb corn AGREEMENT:I hereby certify that f 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 properly 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# F )2696tubbis Co 24-(5 E [gO `c15 Owner/Authorized Agent Signature Dale (Revised 9/23/2016)