4423 S 3RD AVE 2019-05-23 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION "441404 -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'ADDRESS; 2 BUILDING•AREA(if residential,new construction,remodel,or addition), SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: M.. CONTRACT PRICE OF WORK:$ 2._5(7) ,pO„ NUMBER OF DEVICES if low volta•e FIRE ALARM? ❑YES ❑NO ASSOCIATED BUILDING PERMIT#(if a plicable): DESCRIPTION OF WORK: eo,+ =' i. .: ::; A ! '•MIIwtlN11k11111Y }y�y x OWNER NAME, 'Rocklhj TENANT NAME lir Comm Jai):: OWNER MAILING ADDRESS: STREET " � ✓� ^ C Y t�1J•.., •• .. STATE.. .. ZIP t! OWNER PHONE: , C5 . � :.. J WNER EMAIL: CONTRAC ft R NAME: CM i�t, ,Q ,In CONTRACTOR ADDRESS. STREET ��4 t �` �� 20 CONTRACTOR PHONE g1 CONTRACTOR EMAIL: (' , VII CONTRACTOR LIC.#FRE UIF )• ih s _ IVildCITY OF EVERETT BUSINESS LIC.. Q if ); (02046 ° PRIMARY CONTACT: 0 OWNER Q ,CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: � 5q D ildale. CONTACT EMAIL. .corn AGREEMENT:i hereby certify that have read and examined this application and know the some fo be true end 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 tam authorized by the owner of this property fo perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW end 296.200 WAC. City of Everett Official Use Only PERMIT# OwnerlAuthertsed Agent Signature Dale (Revised 9/23/2016)