6930 CARSON RD 2019-01-24 - Laserfiche WebLink

#14P A ELECTRICAL PERMIT APPLICATION I�►�� - 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 SITExINFORMATIO'NN PROJECT ADDRESS: (0 q?() fs.0/I 12-D e'e -) Lrq BUILDING AREA(if residential, new construction, remodel,or addition) 2 CIO SF BUILDING TYPE: 0 SFR-DETACHEDSFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: c I— ' 5` ' ' I ELECTRICAL APPLICATION4NFORMATION; , ' , ' CONTRACT PRICE OF WORK: $ C7 NUMBER OF DEVICES (if low voltage): 0 FIRE ALARM? KYES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: "I� GiVIA Qc ) ct (Joot- 114 K�j 1My �✓th/J et 1 gv17 wares ✓ i rae 1,141/ Cv v4 7I-e✓✓c F-47k CONTACT INFORMATION OWNER NAME: I Ay I(c ' A L/ci✓r L n TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 6 q ec1 C�sw g f) ' -/ s'2-0 CITY ye-Eu-1- STATE.,,y.{/"4 L ZIP q L1 Z G OWNER PHONE: Se —�o SJR(—�O 17 OWNER EMAIL: 14`f ov J � U/1 l t,t34.11 C yngi CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: 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# ENV1104 662 — Owner/ orized Agent"•• ature Date (Revised 9/23/2016)