820 CADY RD 2016-08-17 (10) - Laserfiche WebLink

4LECTRICAL PERMIT APPLICAOL MN CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I vwvw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: L. f, T BUILDING AREA(if residential, new construction, remodel,or addition) C SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX :MULTI-FAMILY-#OF UNITS: _ ❑ COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ ;(A-0`6 (1-) NUMBER OF DEVICES (if low voltage): FIRE ALARM? 'M YES ❑ NO ASSOCIATED BUILDING PERMIT#(if applicable): ; ! DESCRIPTION OF WORK: I } CONTACT INFORMATION -- OWNER NAME: �'l\ , -kms TENANT NAME(If Commercial): + OWNER MAILING ADDRESS: STREET 1E'/a�LAZ, }C CITY t:._.''t C��\"�.2 1 STATE OWNER PHONE:�L� • zcit) • I-A`6 AS ZIP G 7D OWNER EMAIL: CONTRACTOR NAME: L\j CONTRACTOR ADDRESS: STREET 7A {{ ` �,4", CONTRACTOR PHONE: STATE j A -5M CONTRACTOR EMAIL: -U C�( LCA CONTRACTOR LIC.#(REQUIRED): i.�AY1h ,� =yam: `- CITY OF EVERETT BUSINESS LIC.#(REQUIRED): _ �LAb PRIMARY CONTACT: ❑ OWNER b CONTRACTOR ❑OTHER(Please Specify) [CONTACT NAME: CONTACT PHONE: � � CONTACT EMAIL: AGREEMENT:Thereby certify that 1 have read and examined this __ - ca I COin application and know the same to be e . provsionsof 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/am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# Owner/Authoriz��t�re , I Date (Revised 10112/2015)