5823 HIGHWAY PL 2019-01-08 - Laserfiche WebLink

^IP ELECTRICAL PERMIT APPLICATION .441 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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 5 Z BUILDING AREA(if residential;new con ction,remodel,or addition) 15 $F BUILDING TYPE: 0 SFR-DETACHED ,'if'SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$_7,2.3t9 NUMBER OF DEVICES(if low.voltage):.,,,. FIRE ALARM? YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Ntw_ 100 AM? SFS; _----_-_ 'CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial); OWNER MAILING ADDRE S: � STREET /Alto_ Y. SVVV 1.6 700 CIT'V9 d��`a Ilk STATE CA CIT' ZIP CI 00 OWNER PHONE: OWNER EMAIL: { el • CONTRACTOR:NAME: vthet- Lfi v c /vv. CONTRACTOR:ADDRESS: STREET QO 1.0$'. CRY CAA A ' -_ STATE WA ZIP Q Z. CONTRACTOR PHONE:ZS3-l(p3l 7'7-SOX OZ$ (CONTRACTOR EMAIL: pe'�Y111& p�raAdin. '& v til- f. 'r� CONTRACTOR LIC..#(REQUIRED): pV")61 i b3C,Z CITY OF EVERETT BUSINESS LIC,#(REQUIRED):0( 33 C, „ PRIMARY CONTACT: 0 OWNER ('$'+✓ONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: Shanrim. aCONTACT PHONE:,__-.rrJ J` ��f-'/��s'�C IOU_ __ CONTACT EMAIL Xi!rii Yy►1/lr( i ,G,1�1,Q>F AGREEMENT:I hereby certify that I 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 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 PERMIT# I `-1 ..... I55ad-7 E I/ a 4-1 3A OlivnerlAuthorized Agent Signature Date (Revised 9/23/2016)