7621 BEVERLY LN 2019-01-17 - 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 I (E)everetteps@everettwa.gov I www.everettwa,gov/permits PRO E '1'SITE ! )FEfRMAT10t� : PROJECT ADDRES4�S ,.,.�,., v�`u�.... ... �9�,_ z':,. : 1 d' eve qY Lfc-ve ,�ft (��.'t f BUILDING AREA(if residential,new construction,rem I,or addition) SF ,/ BUILDING TYPE: D SFR-DETACHED p0�SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: D►COMMERCIAL USE OF BUILDING; �lY 0�'t..t".4 f m ,1(*I k 1. t Q CONTRACT PRICE OF WORK:$ 1;2-(2 (, NUMBER OF DEVICES(if low voltage):�-}}� FIRE ALARM? D YES C1,1 0 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: -i M nolD0,9 up). .___ .., CONTIGT� iFORM T�N z OWNER NAME: be!e'L . s Li ) ( fl') TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTRE T ) ) W2, f CITY el/Tc yr,i ) STATE I/04 ZIP ] y OWNER PHONE: 1-421-42.2g- q o00 OWNER EMAIL: CONTRACTOR NAME: (, } t}- ' commit-) j C G)`t7 ,5 CONTRACTOR ADDRESS: J STREET/ �(p P3e,v '")! v1 . (.d l ✓Y CRY `e r J STATE )sv i ZIP ql ) 1-) CONTRACTOR PHONE:4ZS-g " 1s-oi 9 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): sry ,, ... ?�j (4--) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 175-7 PRIMARY CONTACT: D OWNER IONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: L.4 3,.5 TM-oY CONTACT EMAIL:Cyw c e1Y01 11,9 skAjhrir cofyiryth v c AGREEMENT:I hereby certify that!have read and examined this application end know the same to be tnie and correct. All provisions of laws and ordinances governing this typ 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! comply with the State Contractors Law 98..27 RCW and 298.200 WAC. City of Everett Official Use Only 110 PERMIT# pe l dpi Owner/Authorized •.,t Signature Date (Revised 9/23/2018)