7020 BEVERLY BLVD 2019-01-17 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION I„viii 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,govtpermits PROJECT SITE INFORMATION PROJECT ADDRESS: 7020 13,everitittiv t BUILDING AREA(If residential,new construction,remodel,or addition) SF BUILDING TYPE: ,FR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION-`INFORMATION CONTRACT PRICE OF WORK:$ 2_50 ,'- NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(f applicable). DESCRIPTION OF WORK: , IVs j IA:c '” ` ', i IIT co TACT INFORMATION OWNER NAME: t I!" TENANT NAME if commercial): OWNER MAILING ADD. S; STREET�7 2 Q "i,j;� Blvd yA p CITY 1 teAr ,..- `�. STATE ' ,'`. ZIP I Gi aO3 OWNER PHONE: {{��,�, OWNER EMAIL: CONTRACTOR NAME: l ►'isc O 9 CONTRACTOR ADDRESS: STREET ' t co aE CITY STATE. A-" ZIP .tqt 2�.�.�LV i[f CONTRACTOR PHONE: 1. 5 CONTRACTOR EMAIL: dtblie h +'rnc , kCONTRACTOR LIC.#(REQUIRER):c pea fk xt(61—1C.��l CITY OF EVERETT BUSINESS LIC.#(RFgUIRED�; PRIMARY CONTACT: ❑OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE 5q � ' i ie CONTACT EMAIL: {', AGREEMENT:I 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 lam authorized by the owner of this property to perform(he work for which application is made and/ comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# -.Le- h E 1 -- 05`4 Owner/Authorized Agent`Signature Date (Revised 9/23/2016)