7425 MCDOUGALL AVE 2019-02-11 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION Nr ai CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 I (E) everetteps@everettwa.govI www.everettwa.gov/permits PROJECT SITE INFORMATION: PROJECT ADDRESS: 7 25 6iCp©u�� A � v YE rei 56-?05 BUILDING AREA(if residential,new construction, remodel,or addition) Mid paha f SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ixMULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Otilc EL. civic AL APPLICATION INFORMAT1OE CONTRACT PRICE OF WORK:$ 1 NUMBER OF DEVICES(if low voltag : FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ` .-----*.A...."-etf. n 1.),,,-6..2_-.• ,,,,., . ,,,,„.„,•• , CONTACT INFORMATION. II OWNER NAME: O risk:124'{ Yk- TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 7 q 25 nitellyta' Atilt eve 6 e CITY /9 STATE q Y 0)-5 ZIP OWNER PHONE: OWNER EMAIL: � I ., CONTRACTOR NAME: 060)/PX--- CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.*(REQUIRED): 13\ CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: , OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONT CT NAME: (tir fm \toa6c.)'r - CONTACT PHONE: t12S Vs 6 (3 AJ"15 CONTACT EMAIL: e1)ISro.,,,J� sq a�„....1 AGREEMENT:T 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 l 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 FEE dop ,cel „....--_ PERMIT* ( r -k.l - 230 ori!gent Signature Date (Revised 10/12/2015)