1602 COLBY AVE 2019-01-25 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION ETT 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 - e,I PROJECT ADDRESS: /‘0.Z. C (2t Ave Vey^ -- �} , 491 - aO BUILDING AREA(if residential, new construction, reoiodel, or addition) -3-200,) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $Z O(9. QO`- NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES NO0 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: j yl X} ^ �'' f i cc s p.@ CONTACT.INFORMATION OWNER NAME: S \es�j V,„ Ay‘�-eY )TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET /2_ c©1 � v..e__ CITY Ff�,f` - STATE (/'.J 4, ZIP -a/ �-� OWNER PHONE: "Z-CAC 511:°164 V coYvl rj "� �j'ZZ OWNER CONTRACTOR NAME: 1.- ,‘pV1 0..) LL../_ CONTRACTOR ADDRESS: STREET el, PVX d] CITY /42brk1in�,k y` STATE WIq ZIP g 2-s CONTRACTOR PHONE: y2.$ 3- ,gyp ee CONTRACTOR EMAIL: /494-1 �i 'ry 2 i 'C� T,�- 11c, h CONTRACTOR LIC #(REQUIRED) � �ZRJ CITY OF EVERETT BUSINESS LIC #(REQuIRED):053,)q PRIMARY CONTACT: 0 OWNER /CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: £/ 5_ )Z3 14,9-.r\ RY°v\� CONTACT EMAIL: /j'4P ( ict) Of, , n4_AGREEMENT::T hereby certify that I have read and examined this application and know the same toobe true an 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 FEE PERMIT# 1117 G ttir pt. '...` Ow Authorized •:.• t Signa a 1Dat (Revised 10/12/2015) 1611.—420