3109 SHORE AVE 2019-04-17 - Laserfiche WebLink

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 I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ,310q Fiore 114()--c BUILDING AREA(i(residential,new construction,remodel,or addition) SF BUILDING TYPE: 1 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX ❑MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL'APPLICATION'INF.0RM4 `IoN CONTRACT PRICE OF WORK: $ ` CD ,o0 NUMBER OF DEVICES (if low voltaye): FIRE ALARM? ❑YES NQ ASSOCIATED BUILDING PERMIT# (if applicable); DESCRIPTIONADF_W.ORK: � � , �. "'I ±5-17.4 " CONTACT IN ORI'I AtION OWNER NAME: jPf)/' ; adish TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 3oq 5 tore ^y C l r`r 3 �� STATE GOZI? OWNER PHONE: 7 OWNER EMAIL: CONTRACTOR NAME: ,}'lf" C 0 9 CONTRACTOR ADDRESS: STREET 14 15. la('ep(dt, fjan CIN t rz STATE rA ZIP CY3 20 k CONTRACTOR PHONE: 155`"I jCONTRACTOR EMAIL: d_t,J 1_e G,mkea+c g I/14CONTI TOR L1C.#(Rrc urpED) e 9.57 fl CITY OF EVERETT BUSINESS LIC.#(REQUIREJ D): I tjp(D PRIMARY CONTACT: 0 OWNER laCONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: Lj ,••,,5 359' 00'550 CONTACT EMAIL: citJ( V'G l •OW() AGREEMENT:l hereby certify that flit have read and examined this application and know the same to be true end correct. All provisions of laws and ordinances governing this type of work wig 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 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 � � PERMIT# peb6?-- Vi .02 ?. E 1 b - 20 (� Owner/Authorized Agent Signature Date (Revised 9/23/2016)