2122 VIRGINIA AVE 2019-04-18 - Laserfiche WebLink

aLLECTRQCAL PERATI ANUICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwagov J www.everettwa.gov/permits „ . PROJECT SI 'E INFO MAT O PROJECT ADDRESS: I � U GL 111-e .e s€-rr qa,.O BUILDING AREA(if residential,new construction,reml I, or addition) SF BUILDING TYPE: 0 SFR-DETACHED SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: H. 0 P • ELECTRI AIL APPLICATION IINFORMA11ON CONTRACT PRICE OF WO :$ 1 000 NUMBER OF DEVICES(if I w voltage): FIRE ALARM? 0 YE 117, 0 ASSOCIATED BUILDING PERMIT#(if applicable): LOO eL DESCRIPTION +OF WORK: 'VOW2< �(Ae_c- ' Q Ur `�-`.2� Vl r �'vi/e_rQ (Pp f )es (.t) < cam- 1 t 0 Yvt �.P j 2�' O t\ Gad e htDUS2 ;1 ea of aern fieek �l 1� (Ari PP A P';Pe_ -ro J4 ouSe_ w ec'e E- ;cfl.. Al/ (9c K n/ CONTACT;INFORI1AATiON• . OWNER NAME: )4p (m 14,40A. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET Dq t!� r j t CL CfTY �J-e�Q � STATE (I—)/3` ZIP gge;2.0 / OWNER PHONE: L1 j .3• C) �(p, OWNER EMAIL: flr2 7 i 74 go I CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): CITY OF EVERETT BUSINESS LIC.#(REQUIRED): V PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: �/ �/ CONTACT PHONE: L/9s 360 5402 leNcl 'i' l<-e WIi7 Cit714 04 CONTACT EMAIL: y✓e7 g 765 5 eD 40/. f_ot AGREEMENT:T 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 296.20b WAC. City of Everett Official Use Only FEE PERMIT# „re, XV/ / caner/A=�orIze.�ge Signature F Date (Revised 90/12/2095)