4416 RIVERFRONT BLVD 2019-04-29 - 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 ADDRESSV1/4.j) wK on avd MfflCi a C BUILDING AREA(if new construction,remodel,or addition) SF BUILDING TYPE: ❑SFR-DETACHED $FR-ATTACHED In DUPLEX 0 MULTI-FAMILY-#OF UNITS: D COMMERCIAL USE OF BUILDING: ��,- n&4 ,"- ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ q f OO NUMBER OF DEVICES(if low voltage): FIRE ALARM? ©YES (INO 1 cy ASSOCIATED BUILDING PERMIT#(if applicable): A ,sO ('j '- (r15 DESCRIPTION OF WORK: VIZUZ C CA)J t Ca.c CONTACT INFORMATION OWNER NAME: 1a[a(L rail( p!CC TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET kA`k.'lQ V:lvc-40& e CnY EV ekekV STATE IW 1 21P Cil3arl] OWNER PHONE: (‘...4)-6)810^"TTA OWNER EMAIL: IVA CONTRACTOR NAME: GgeenWnelit A A e- CONTRACTOR ADDRESS: STREET .5 s Mack 1 + g 1 CnY SPCIVAt. STATE WR bL ZIP Qt a(1- CONTRACTOR PHONE:t�p�"'Jg�-MLSC CONTRACTOR EMAIL:\C,O‘Lale V p gVient xt'Y✓.�haAnt..). CO�rl CONTRACTOR LIC.#(REQUIRED):C?_E E(•.1HC.BL1G©T CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: ID OWNER KONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: `�h CONTACT PHONE: ( )" ` l ` ' t can ft CONTACT EMAIL: �szi r mU cI J?� �+ t AGREEMENT:I hereby certify theflireve reed and examined this application and know the same to be true and correct. AI!provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting ofa permit does not presume to give authority to violate or cancel the provisions of any other slate or local law regulating construction or the performance of construction. That!am authorized by the owner of this property to perform fire work for which application is made and comply with the State Contractors Law 18.27 RCW and 296.200 WAG, City of Everett Official Use Only PERMIT# *3)Ii( E1bOgv- Owner/A arized Agent Signature Date (Revised 9/23/2016)