1026 W MUKILTEO BLVD 2019-02-12 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 410. - - CITY OF EVERETT PERMIT SERVICES .�. 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits { PROJECT SITE INFORMATION PROJECT ADDRESS: 1026 W Mukilteo Blvd BUILDING AREA(if residential, new construction,remodel,or addition) SF BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Home ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 3,000 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ®NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: install 15A arc fault protected circuit- K&T Certification - CONTACT INFORMATION W OWNER NAME: Ronald Lagman TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1026 W Mukilteo Blvd CITY STATE ZIP OWNER PHONE: 206.683.1721 OWNER EMAIL: CONTRACTOR NAME: Arrow Insulation Inc CONTRACTOR ADDRESS: STREET PO Box 1233 CIT,, Mount Vernon STATE WA ZIP 98273 CONTRACTOR PHONE: 206-682-9276 CONTRACTOR EMAIL: service@arrowconServation.com CONTRACTOR LIC.#(REQUIRED): ARROWII855M 1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052485 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-686-0002 Logan Frederickson CONTACT EMAIL: Ifrederickson@arrowconservation.com 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# a7411 *12/6\7,0k E %f()' s— ?1 Owner/Authorized Agent Signature Date (Revised 9/23/2016)