5527 BROADWAY 2019-05-31 - Laserfiche WebLink

4Err ECTRICAL PERMIT APRICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT' SITS;INFORMATION — u PROJECT ADDRESS: 55 tar0 4a W 4l } tV Q?tt Qb ava3 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE:'SFR-DETACHE• =%` R-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: S adnc..g., /G ELECnRICAL APPLICCATION INFORMATION CONTRACT PRICE OF WORK:$ 110 V NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES I,NO ASSOCIATED BUILDING PERMIT#(if applicable): (...i-)°3 0 �a DESCRIPTION OF WORK: Ek-e- Pi(\ ' ''('" I 3;,0) A SQjev cz- t€, )Coynn'vnv4)c) 'Oh CONTACT IfNFORMATION OWNER NAME: -\ Qr coa. TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET �J ?Mac�pA A��j (o4.1 S' .4 �t /1�@ CITY LOACC, �l")'3"'IS y 1110/01\ " STATE ` ZIP `"I G7 aS OWNER PHONE: `1'as wig 0S�T)) OWNER EMAIL: L)(31,(C ►I\OY1t\Q S Q) MS'fl 0 CD 1V1 CONTRACTOR NAME: O\t5 En Y1s . CONTRACTOR C- CONTRACTOR ADDRESS: STREET 11 lay M.\U \ S r- _t (� a"-Q t, CITY SY10\10S� STATE ,r4 4. ZIP `Ily CONTRACTOR PHONE: y4S 3 ('( Ia")S CONTRACTOR EMAIL: ILIfv1Y‘SoV1S .L 04.3 t 4l1,CALM CONTRACTOR LIC.#(REQUIRED): SoI\.S el Skt9 coq CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: 0 OWNER 11g1 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: "3.00 SIS±s CONTACT PHONE: 'g 1.S 3yN Iai CONTACT EMAIL: ; .eyly1sr)V;5 J.,(I)1%n0.1 . Co lAn AGREEMENT I hereby certify that I have read and examined this application and know the same t 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 lam 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# E gbq — d23 Owner/Authoriz Agent Signature Date (Revised 9/23/2016)