5301 W HIGHLAND RD 2019-03-27 - Laserfiche WebLink

L'rECTRICAL PERMIT APPLit•ATION 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 www.everettwa.gov(permits ..» PRO.IECT SITE,INFORMATION PROJECT ADDRESS: • ) '•t A.i r',441 i rF ` BUILDING AREA(if residential, new construction, emodel,or addition) SF BUILDING TYPE: • SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING; CONTRACT ELECTRlCAL``�M'PI.ICII`TlOt+l+� NF+'C!]tt141�;"T'`1ON PRICE OF WORK: $ ,ca NUMBER OF DEVICES (if low voltage): ASSOFIRE ALARM? ❑YES ❑ NO CIATED BUILDING PERMIT#(if applicable): DESCRIPTION oE.W_oRK:_ Gtr-OLA, 'AS R 'croNtvey !NFORMAlr OIn OWNER NAME: hd A (4- TENANT NAME If Commercial : OWNER MAILING ADDRESS: STREET 53j W " r J44040 -! STATE Vit 411 ZIP OWNER PHONE: ? E OWNER EMAIL: CONTRACTOR NAME: 0 CONTRACTOR ADDRESS: STREET ) 1 ' Wo kicKt CITYSTATE 4`C" ZIP qi.ft20 CONTRACTOR PHONE: ♦ *live CONTRACTOR EMAIL: t '�j r _cCTATRstCTL�RZTC�'�zPciuti�Er�: .l1 ei rr1 +� � �41 r14( CITY OF EVERETT BUSINESS LIC.#REQUIRED): $ PRIMARY CONTACT: 0 OWNER CIS CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: n ly� CONTACT PHONE: �- �iE? CONTACT EMAIL; dntS �� D AGREEMENT:I hereby certify that 1 have reed and examined this application and know the same to be true and correct. All provisions laws and0ices 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(he 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 RC W and 296.200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature Date (Revised 9/23/2016)