3010 EVERETT AVE 2018-09-07 - Laserfiche WebLink

//IP LECTRICAL PERMIT APPLICATION ---,- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.gov www.everettwa.gov/permits PROJECT SITE INFORMATION: PROJECT ADDRESS: 3010 Eu we- 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: 0 COMMERCIAL USE OF BUILDING: -J,e.c{ e. ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ � Q QQ NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -U ge ve +L_r!T t.,RS =AS-NAL w 1--L-0 or A ? / T • CONTACT INFORMATION OWNER NAME: 3 {-e-t C Pert:e3 TENANT NAME(If Commercial): c- e-- OWNER MAILING ADDRESS: STREET S2-t Z l(,Ar- e C(c VQ_ ern Eu are-t+ STATE GIA zip I 6243 OWNER PHONE: L12 -670- 7 2..q 7 OWNER EMAIL: cs{1.41A4Q,Pet-f-e$ e (gam cA 37: 1' CONTRACTOR NAME: d CJ('-CC CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: al OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: I-11C- Ego- 7 z cf 7 CONTACT EMAIL: S- [A-proper-ties t. CCAd 6T 1Ii7 AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions oflaws 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 RC W and 296.200 WAC. City of Everett Official Use Only FEE 5b PERMIT# 5-7 /q-Lai 8 EW(51- 001 Owner/Authorized Agent Signature Date (Revised 90/92/2095)