3109 8TH ST 2019-05-23 - Laserfiche WebLink

,.0r" ELECTRICAL PERMIT APPLICATION + ✓q - - CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 982001 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov( www.everettwa_gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ( o 43 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: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 16cj,, NUMBER OF DEVICES(if low voltage): FIRE ALARM? ❑YES' 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): _ DESCRIPTION OF WORK: [ (.L�.t�' t 1 ..Ci` L ; --" a (an, kv AI Vff" CAALi Pa CONTACT INFORMATION OWNER NAME: [i i 2.-t MASV:63.W 1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET i - f t p / 7-- CITY 1 Li =ySTATE -, ZIP '+ t OWNER PHONE: 511 I -, 1 -- Lt 5- OWNER EMAIL: CONTRACTOR NAME: (..-; U2. 1 k....) 81/4-UP' 1.")1 r ‘../t6 CONTRACTOR ADDRESS: STREET 'at-2v -cac, ,,,,_ CITY f.,% -- STATE Q:� r ZIP 1 • f CONTRACTOR PHONE(Lizo -2„5-7_-Af f CONTRACTOR EMAIL: I Le"..-c , , 5 6911 4/zpr C43,1,,,c CONTRACTOR LIC,#(1REG1UIFIED):Lt el Z,, ", r--, . CITY OF EVERETT BUSINESS LIC.#(1REOUIRED) 37?' q PRIMARY CONTACT: D OWNER ,,CONTRACTOR 0 OTHER(Please Specify) CONTACT A E; : CONTACT PHONE: (e../Z-) + ,c-Z, 3/741 / v CONTACT EMAIL; ; +&'l i eta AGREEMENT.:I hereby certify that 1 have mad and examined this application and know the same tobe true and correct. Alt provisions of laws and ordinances governing this type of work will be completed whether specified herein or not. The granting of a pennif does not presume to give authority to violateor 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 298.200 WAC. City of Everett Official Use Only kte„....v." / „ PERMIT EI ( H Owner/Authorized Agent Signature Date (Revised 9/23/2016)