1712 HEWITT AVE 2018-09-11 - Laserfiche WebLink

EL CTRICAL PERMIT APPgkATION Imo►' ;- - 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 INFOR TION PROJECT ADDRESS: 17ice_ 440 L);-ff• Ave 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: COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ �St7 NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Tr (( � ,�,it 1 1-4, c O,, 14' Ula , CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): pi ecj211 OWNER MAILING ADDRESS: STREET J CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: ,j DP,c cly CONTRACTOR ADDRESS: STREET / /9/J/i0 - 1-4"/ p 1�' ' A CnY `4r)LJOV� STATE LA ZIP ,e2yo 4 CONTRACTOR PHONE: LLZ-S—37 �'—r�a 2 CONTRACTOR EMAIL: q mtz?„c ( S f= S'^r y,C. C 64, CONTRACTOR LIC.#(REQUIRED): j - CITY EVERETT BUSIP..IESS'(IC.#(REQUIRED):�j Z1?-0 PRIMARY CONTACT: D OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Park_ ��—� 3—o�9-zc 3orytl CONTACT EMAIL: j�m— �,: Cr - AGREEMENT:I hereby certify that I have read and examined this application and know the sambe true and correct.All pions 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 lam 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 PERMIT# �/�► 2_9' EnD2-D Owner/Authorized Agent Signature Date (Revised 9/23/2016)