2630 HOYT AVE 2019-03-27 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION 40j#61111,—A. vailii ,- -,- CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810I FAX 425-257-8857 I (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION:. PROJECT ADDRESS: 2_,(730 NO&Sk- A g. �nik * 11- BUILDING AREA(if residential,new construction, remodel,or addition) ------ SF • BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: (1J- Men _.__-. ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 30t)s NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0-YES tft-Ntr--- ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: 1_cSrG.\- e36c-- r Sexy ic.e SO cotter can be rc S Tec A-o U.Ai\- * - t g ,CONTACT INFORMATION. OWNER NAME: ./1-)C\.( MO Is I'1S 0/1 TENANT NAME(If Commercial): JCL(.(AAf- OWNER MAILING ADDRESS: STREET 2-3 1v9 1354' S4- 1J& CIT �( Y Cyc✓\�1-c ('01.11 s STATE�A ZIP CU LS-Z. N E:OWNER P -0 6- t 0 us CO HON9' S - H 9 2 OWNER EMAIL:OE;t) rCOS e ICC-i-r i( . M . _.. . . .. ... .. ..... .. .,.. . . . .. . .. ,. ... . . ...�.. .. . . . .._ 1 `. .. -. . .. ,.. ... .. . CONTRACTOR NAME: "D' U D"1 0(o I (17A CONTRACTOR ADDRESS: STREET lei KA. S4e 1 AS ST. J-7 CITY rOSe btArq STATE OR ZIP C/7-` (0 CONTRACTOR PHONE: r� e ted-r cto Sei- CONTRACTOR EMAIL: VJ i\Ca) rCke.tec t"r1c_lUu). con CONTRACTOR LiC.#(REQUIRED): (Z e ?Co- CITY OF EVERETT BUSINESS LIC. 6(Q' PRIMARY CONTACT: ❑OWNER 8N .#(❑CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 2,0 b_c' s _Qt t q Z \\,\ CONTACT EMAIL: Utilkk€ rek e tf FIC A) , COM 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 focal 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! comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE . 4. I DI) i6D- PERMIT# l /t-2 E n (,p �1 - Owner/Authorized Agent Signature Date (Revised 10/12/2015)