5113 WOODLAWN AVE 2019-05-22 - Laserfiche WebLink

ELECTRICAL E 1WT APPLICATION' CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 FAX 425-257-8857 f (E)everetteps@everettwa.gov( www.everettwa.gov/permits PROJECT SITE INFORMATION 'PROJECT ADDRESS: 5113 WOODLAWN AVE, EVERETT, WA 98203 BUILDING AREA(if residential,new construction,remodel,or addition)1340 SF BUILDING TYPE: 0 SFR-DETACHED ❑SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: PRIMARY RESIDENCE ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 1500 NUMBER OF DEVICES(if..low..voltage): . FIRE ALARM? ❑YES ®NO ,ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: REPLACE KNOB AND TUBE WIREING CONTACT INFORMATION •WNER,NAME: KONRAD HARMON TENANT NAME(If Commercial) OWNER MAILING ADDRESS: STREET 5113 WOODLAWN AVE cITY EVERETT STATE WA ZIP 98203 PHONE 360-350-8798,,,,,, , TOWNER EMAIL: KONRADH@ELECTROIMPACT.COM ONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: 1CONTRACTOR EMAIL: ONTRACTOR LIC.#.REt3UhRED): tory OF EVERETT BUSINESS LIC.*REQt}IRED): PRIMARY CONTACT: ®OWNER 0 CONTRACTOR 0 OTHER(Please Specify), em ONTACT NAME: CONTACT PHONE: 360-350-8798 KONRAD HARMON CONTACT EMAIL:KONRADHi ELECTROIMPACT.COM AGREEMENT:I hereby certify that I have read and examined this application end 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 19,27 RCW and 296„200 WAC. City of Everett Official Use Only PERMIT# Owner/Authorized Agent Signature bate (Revised 9t23/2016)