5016 NICHOLS PL 2019-02-12 - Laserfiche WebLink

14ETT ELECTRICAL PERMIT APPLICATION 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( www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 67W ,44cAC7[ g 7 BUILDING AREA if residential,new construction,remodel,or addition) SF BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UMTS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 9re). (12 NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES W40 ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Jj 7� ,v( �� g'a 43(..9x, le L ) t 'r pct Gt U-1:"T"- CONTACT r CONTACT INFORMATION OWNER NAME: bA Vi (t)CC il he CIS TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET SbG�Q - X 11 C..kb/' crry ( STATE to ZIP ‘"YC-CJ3' OWNER PHON 4Z� 7O— 4667 OWNER EMAIL: J¢ZrArligad S'060 LS CONTRACTOR NAME: {�' f jfid r(J ( r -` ' CONTRACTOR ADDRESS: STREET /�.l Z0 G rl.(- G CITY CIJ L STATELUb4 , ZIP 9c. CONTRACTOR PHONk YGS, '-2-3((-r CONTRACTOR EMAIL: geka J2 S SPe64_.t?►atm. CONTRACTOR LIC.#(REQUIRED):LvSt�f CITY OF EVERETT BUSINESS LIC.#(REQUIRED):QO7 q 5S' PRIMARY CONTACT: ❑OWNER yCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:( 4 c) 508-67J )< L f LCA CONTACT EMAIL:}4._0‘/dt Ss Mtva,(Sp AGREEMENT:I hereby certify that I have read and examined this application and know the same to be true and correct. Al!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 lam 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# E PBOig--.61(-16 Owner/Authorized Agent Signature Date (Revised 9/23/2016)