4004 COLBY AVE 2019-07-08 - Laserfiche WebLink

OrEn" 1111.ECTRICAL PERMIT AIICATION 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 - C PROJECT ADDRESS:400c Ni AV-e, E,0€M- WA poo�/ -t BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: o SFR-DETACHED o SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: CA'[��C ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ NUMBER OF DEVICES(if low voltage): I FIRE ALARM? $YES o NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 1W .sA`Cl. O\ C- (6. Ae S cc(6.00 wvo v-s, re)(,m � CONTACT INFORMATION OWNER NAME: i-C- Cj\11(�,L, TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET® ZCDX ^ S 1 CITY ag-QlV4- STATE biA- ZIPI \3 OWNER PHONE:IAD-5aq Vo as IOWNER EMAIL: CONTRACTOR NAME:Gla).(cAACA..VI r Vi\f CONTRACTOR ADDRESS: STREET MLA ML I dAV'e, 5 STATE l ZIP gc. C 1 CONTRACTOR PHONE-0.' 6 0, N LtS CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): AQ.OSA 4Z8 CITY OF EVERETT BUSINESS LIC.#(REQUIRED) Z1k PRIMARY CONTACT: o OWNER o CONTRACTOR ,OTHER(Please Specify) 1C.CUAA- CONTACT NAME: CONTACT PHONE d aco { ( ,�t N.)6(49�C1C+tk U�J� P,/)\ CONTACT EMAIL:Fi\e.W\S e (�Jt r A2 y'j ,Com AGREEMENT: I hereby certify that!have read and examined this application and know the same to be true and correciti All provisions of laws and ordinances governing this type of work will he 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 1 am authorized by the owner of this property to perform the 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# \kaCA1 � E I V°Oh Owner/Authorized Agent Signature Date (Revised 9/23/2016)