1402 SILVER LAKE RD 2019-04-17 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION ",4X-11-a > , 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 I www.everettwa.gov/permits PROJECT ADDRESS: 1402 Silver Lake Rd BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: Et SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: Residential S LE i�1 AL APPLICATION INFORMATION ,` CONTRACT PRICE OF WORK:$ 325 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Install outlet for sump pump (not tied into plumbing system) in crawlspace .0 I T• ACT INFORMATION , OWNER NAME: Anna Born TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET 1402 Silver Lake Rd CITY Everett STATE WA zip 98208 OWNER PHONE: 206-963-1584 OWNER EMAIL: CONTRACTOR NAME: Cisco Electric, Inc CONTRACTOR ADDRESS: STREET 22612 92nd Ave W cry Edmonds STATE WA zip 98020 CONTRACTOR PHONE: 360-618-3038 CONTRACTOR EMAIL: maria@ciscoelectric.com CONTRACTOR LIC.#(REQUIRED): CISCOEI914DE CITY OF EVERETT BUSINESS LIC.#(REQUIRED):042432 PRIMARY CONTACT: 0 OWNER 121 CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 360-618-3038 Maria Nicodemus/Cisco CONTACT EMAIL:maria@ciscoelectric.com AGREEMENT:I hereby certify that!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 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 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 29 2-6l E 43 \,(01z)k (Revised 9/23/2016) O /Authorized Agent Signatur Date