1417 TTEREVE DR 2019-04-17 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION /11111PO4 ---.4, - 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: 1417 Ttereve Drive BUILDING AREA(if residential, new construction, remodel,or addition) C SF BUILDING TYPE: El SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 1 0 COMMERCIAL USE OF BUILDING: Home ELECTRICAL.APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 2500 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Rewiring the existing front entryway lighting - rewire kitchen light fixture and switch box CONTACT INFORMATION OWNER NAME: Gary Backenstose TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Same CITYb--Verebit" STATE Wit ZIP Rg2.01 OWNER PHONE: 425.350.8146 OWNER EMAIL: garybackenstose@gmail.com CONTRACTOR NAME: Arrow Insulation Inc CONTRACTOR ADDRESS: STREET PO Box 1233 CITY Mount Vernon STATE WA ZIP 98273 CONTRACTOR PHONE: 206-682-9276 ext. 2 CONTRACTOR EMAIL: Service@arrowconservation.com CONTRACTOR LIC.#(REQUIRED): ARROWII855M1 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 052485 PRIMARY CONTACT: 0 OWNER i71 CONTRACTOR . 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 206.682.9276 ext 2 Logan Frederickson CONTACT EMAIL:service@arrowconservation.com AGREEMENT:I hereby certify that t 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/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# 0-a67 )1 / 1g E Lq O \ 22 Owner/Authorized Agent Signature Date (Revised 9/23/2016)