5612 1ST DR W 2019-05-22 - Laserfiche WebLink

• ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 l FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT.SITE 1•N ORMATI9 I11;. .. PROJECT ADDRESS: .‘„TC,c02 �g W BUILDING AREA(if residential, new construction,remodel,or addition) -C- T-1 SF 3 BUILDING TYPE: 0 SFR-DETACHED IA-SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 'SUS$.' • ELIECTRICAL APPLICATION INFB RpI1M #TION CONTRACT PRICE OF WORK:$ J pPD • NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES Ea.NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Pc I `r' t-5 _ CONTACT INFQRMATIO.N OWNER NAME: AA(p(3 vires TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �CO (.4ST Q� 1 C crryVA-Yr?-421c-ft— STATE ()kJ ZIP 3 3 OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: 1 N �SK `�P 1Y Z. -57_1z)(L— I CONTRACTOR ADDRESS: STREET (p ' `3 `r 6t •q(7-14 c 4 CITY LIJA✓ STATE 1.)..)i- ZIP / S b 3 CONTRACTOR PHONE: 85—t, I? 5 CONTRACTOR EMAIL: 90.1.)fe.-3f- f r2 �e_./.4.\ CONTRACTOR LIC.#(REQUIRED): S'L3g 9 Zf CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Co .." • .. �•��., a PRIMARY CONTACT: 0 OWNER ICONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: ZD(p 8 4 9 5 8 5t)t..) CONTACT EMAIL: AGREEMENT::I hereby certify that l 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 l 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# • itspiii/' 1� o E �t' 2)4 Own: uthorized Agen rnature •-te (Revised 9/23/2016)