908 GRAND AVE 2019-03-21 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION '0464 CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 FAX 425-257-8857 (E)everetteps@everettwa.gov 1 wvvw,everettwagov/permits PROJECT SITE INFORMATION PROJECTADDRESS I ( BUILDING AREA(if residential,new construction, remodel,or addition) t SF BUILDING TYPE:\ASFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES it NO ASSOCIATED BUILDING PERMIT#(if applicable); DESCRIPTION OF WORK: 11°A,-;\IL:2)L t c T + ? 4O1fTT- „ • CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET qt..k ClaVtr- 414e: cr/Y f:\I STATE \Pia. Z q 2 C. OWNER PHONE: 2_5 CW:DcA, 'OWNER EMAIL: c . CONTRACTOR NAME:?)GPC f\J U.N CONTRACTOR ADDRESS;iirt) STREET J4± Pj NIE CM, g V Z'ON/ ;::) STATE CONTRACTOR PHONE: 1'125°ZP. ?c")4144 CONTRACTOR EMAIL .\ CA'NV\NJ CONTRACTOR LIC.CREQUIRE01: F3(1;4,1 jctry OF EVERETT BUSINESS LIO*REouiRED): PRIMARY CONTACT: DOWNER iCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 14i CO Q., C4tsyl \lopt CONTACT PHONE: 1; CONTACT EMAIL: \ ,(Cr AGREEMENT:I hereby certify that.1 have read and examined this application anti know the same to be two 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 taw rogulahng 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 comply with the State Contractors Law 18.27 RCW and 296.200 WAG. City of Everen Official Use Ord)? PERMIT# . , 1,/ / / 2 E Owner/A horized Agent Signature I Oat (Revised 9i'21/2016)