4018 HOYT AVE B 2019-03-27 - Laserfiche WebLink

hiLECTRIIGAL PERMIT ALICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 (E)everetteps@everettwa.gov www.everettwa.govlpermits PROJECT ADDRESS: (g 521,171-- �{,{p� ) , si fr I BUILDING AREA(if residential,new construction, re odel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR ATTACHED k'6UPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: • ELBORICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 0 NUMBER OF DEVICES(if low voltage):• FIRE ALARM? ❑YES 221-NO ASSOCIATED BUILDING PERMIT# if applicable): DESCRIPTION OF WORK: A , A ti_ 0 C-IJAr r `eh 11 O � .* = .4-- 1.'ivilrir 4/de, 000 .:: - - CON'T'ACT INIFORiVtATI®N::: OWNER NAME: Of4 / • ©' C'Jf v�� TENANT NAME(I Commercial): OWNER MAILING ADDRESe STREET rookI:4) ' .2.4 a CITY SQ O.v STATE Wit ZIP 701.2_OWNER PHONE: 69-4T�� OWNER EMAIL: ,5j�( �/��f QO�I' /N) � M CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: DOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: 64/ _j/, /�. /CONTACT PHONE: 2 b 3 70 v / CONTACT EMAIL: j f! iojjt/eSil ,c- AGREEMENT.T hereby certify that!have read and examined this application and know the same to ble 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!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 FEE 41u. PERMIT# fa/ /110.P. E 1 12q Owner/Authori -i Agent'Signature Date (Revised 10/12/2015)