820 CADY RD BLDG G 2019-01-03 - Laserfiche WebLink

OLECTRICAL PERMIT AtIC STI®trl CITY OF EVERETT PERMIT SERVICES OL 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 11- , BUILDING AREA(if residential, new construction, remodel, or addition)' SF BUILDING TYPE: ElSFR-DETACHED ❑SFR-ATTACHED ElDUPLEX MULTI-FAMILY-#OF UNITS: El COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ` 7_4 1D NUMBER OF DEVICES(if low voltage): FIRE ALARM? 'Q YES ❑NO ASSOCIATED BUILDING PERMIT#(if applicable): ;4 DESCRIPTION OF WORK: � u�}�� -r?�y CONTACT INFORMATION OWNER NAME: l TENANT NAME(If Commercial): i�'Alf�C OWNER MAILING ADDRESS: STREET �'�LLj ;zC_L CITY �V��- '� STATE NA) ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET STATE r, ZIP CONTRACTOR PHONE: 'LS• , tJt ` CONTRACTORE MAIL: �, ( �JJ CONTRACTOR LIC.#(REQUIRED): `��-)�EC� .,4� �. ..,� CITY OF EVERETT BUSINESS LIC.#(RECIUIRED PRIMARY CONTACT: ❑ OWNER IS CONTRACTOR ❑ OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lu� ,C"l l/�0t CONTACT EMAIL- Vtt C }Lt (� ^) AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of taws 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 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# r �.•� I Ll E OWnerlAdthorized Agent Signature Dale (Revised 10/12/2015)