5811 HIGHWAY PL 2019-01-08 - Laserfiche WebLink

�,--� ELECTRICAL PERMIT APPLICATION �+', CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET,EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ' QQtt� BUILDING AREA(if residential,new con uction,remodel,or addition)'' 1 t?.�, SF, BUILDING TYPE: 0 SFR-DETACHED ,,SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS;.. 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION,INFORMATION CONTRACT PRICE OF WORK:$7 O17 . . NUMBER OF DEVICES;if low voltage): FIRE ALARM? YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: I ,w- 10 MV SF.121 CONTACT INFORMATION OWNER NAME: f1k\G111.1 i, TENANT NAME(It Comn1o iiii); OWNER MAILING ADDRESS: STREET Z!.13OO Vichry VD 5TE 700 CINUBAlp,l11 it STATE A _-:.- --.---. ZIP �JW�--..,-- OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Ek1,0.61(y Int. CONTRACTOR ADDRESS; STREET 90 t.o)(" 70g-7 ..:: CITY COViVbin ... STATE WA _.. ZIP Q YO ao CONTRACTOR PHONE:23 u'3I 1f SQX ein CONTRACTOR EMAIL:_ 'G , YOVidif, ,ile krk v114- -_ CONTRACTOR LIC:;#(REGUIRED): PAIM V i E I-.I03Lt. CITY OF EVERETT BUSINESS LIC.#(REQUIRED):oil•,?z PRIMARY CONTACT: 0 OWNER DitCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 3111trin n ,€-t. CONTACT PHONE: Z S3 X31 -77Sox l a[gig CONTACT EMAIL`ft pra y • - citt AGREEMENT:l hereby certify that!have read and examined this application and know the same to be true and correct, All provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. That tam authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT#. LI -1.$-1 Elio - z-5 Owner/Authorized Agent Signature Date (Revised 9/23/2016)