10121 9TH AVE W 2019-06-05 - Laserfiche WebLink

#1111°'0%4 ,�----4 vitill •ECTRICAL PERMIT AP�ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT,WA 98201 (P)425-257-8810 I FAX 425-257-8857 f (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: ioka\ cA'e., W BUILDING AREA(if residential,new construction, remodel,or addition) SF BUILDING TYPE: o SFR-DETACHED o SFR-ATTACHED o DUPLEX o MULTI-FAMILY-#OF UNITS: _COMMERCIAL USE OF BUILDING:S ) ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ -)CC) NUMBER OF DEVICES(if low voltage): ' , FIRE ALARM? .YES o NO ASSOCIATED BUILDING PERMIT# if a••iicable : DESCRIPTION OF WORK: t A2‘011 1 A eS 'c c AO Md1\ter' ✓\ cAo caDITY\ CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): C(9her 1 C) CLCa al/ - OWNER MAILING ADDRESS: STREET P© � 1-1 c 3 J CITY e i STATE IAJ A- ZIPc1 W OWNER PHONE:D;C)(0.l 4(-( ` !OWNER EMAIL: CONTRACTOR NAME:G71 ZL rd NAME:CvI zerdl(W\ Sew-i CONTRACTOR ADDRESS: STREET 1.1^,{` 1 `c , i- /Y—.. B ' CITY SeN. e Q STATE WA- ZIP f 61 z1 CONTRACTOR PHONE;X0(0)40SCONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):Gv iz S;I;S)Z3ICITY OF EVERETT BUSINESS LIC.#(REQUIRED):O 4L3 PRIMARY CONTACT: o OWNER o CONTRACTOR itt OTHER(Please Specify)P-c\'CCI(\* CONTACT NAME:a? itCyNo, 1e. � CONTACT PHONE: (D ato5C13 ex - p.,€L CONTACT EMAIL: Skelio�a auturdi an SeCOr(i-.. ,C wj AGREEMENT:I hereby certify that!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 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 296.200 WAC. City of Everett Official Use Only PERMIT# _ \�,/ao I ,-1 E n 12- 1 si Owner/Authorized Agent Signature Date (Revised 9/23/2016)