2123 HARRISON AVE 2019-06-03 - Laserfiche WebLink

Ca 3e) 7 41677- ELECTRICAL PERMIT APPLICATION 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 f www.everettwa.gov/permits PROJECT`SITEINFORMATION.:;;'::; ;. �y' :' �....� PROJECT ADDRESS: i 3 � ..�/,Citi/ /�'t/4 k 1/ 1grr- /;e�// BUILDING AREA(If residential,new construction,remodel,or addition) SF BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: tf .S 1;•,/- f�An7AZi ELECTRI AL: PPLI ' G ..A . QM::INt=.ORMATtON:::::::<:.::<;:> CONTRACT PRICE OF WORK:$ / ae7, 0 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Afri Vi21 / foeVi 1 / OWNER NAME: 6 06 ti15.- /V TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET r2/�]�"j /� e y A / CITY (:.•" fr 1 t r STATE iil /"7 ZIP t/�,�° OWNER PHONE: & -- 33/— / OWNER EMAIL: /0/t/ePRjPa`' F4e)S.62 6-4411/4, (gyp CONTRACTOR NAME: .-- �i ,;".- �- ..� C"- c , c _rD CONTRACTOR ADDRESS: STREET ci /A 3 ifiebeeiew / J r�'� CITY if,F1,Zi LT STATE 14 • ) ZIP 47V 411 - CONTRACTOR PHONE: l,rx✓6- - / : CONT R EMAIL: EV)/_VV"r#'L)frt ivOgo /'? • .4 CONTRACTOR LIC.#(REQUIR ):CE-4-e2 � 'hbLi 5' CITY OF EVERETT BUSINESS LIC.#(R;.UIRED): 5.615,/ PRIMARY CONTACT: 0 O NTRACTOR 0 OTH lease Specify) CONTACTNAME:� CONTACT PHONE: 4-2.-c- ,. .7 / 3 3 AY'ki./ Th /--°y dr2,;)&"—:— CONTACT EMAIL: AY ►Aer_ 'lerDE- recaC'./19 T. 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 end 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 f 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. (OO o City of Everett Official Use Only PERMIT# 014 11 E n \ \ 1'D-1 Ownelt/Authorized Agent Signature Date (Revised 9/23/2018)