9326 16TH DR W 2019-06-05 - Laserfiche WebLink

--- 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 I www.everettwa.gov/permits PROTECT SITE INFORMATION PROJECT ADDRESS; 9326 16TH DR W 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: A/C - ELECTRICAL APPLICATION<INFORMATON CONTRACT PRICE OF WORK: $ 350 UMBER OF DEVICES,(if low voltage): I 'FIRE ALARM? 0 YES 0 NO -ASSOCIATED BUILDING PERMIT#(If aIt.icabl): YV1 t QA-bl,41) DESCRIPTION OF WORK: A/C CONTACT• ;INFORMATION OWNER NAME:JOSEPH MCCARTHY TENANT NAME If Commercial OWNER MAILING ADDRESS: STREET 9326 16TH DR W cTr EVERETT STATE WA ZIP 98204 OWNER PHONE: 425-609-3315 OWNER EMAIL; CONTRACTOR NAME: BLACK LION HVAC -CONTRACTOR ADDRESS: STREET 11001 118TH PL NE c,TY KIRKLAND STATE WA ZIP 98033 CONTRACTOR PHONE:4258143944 ,CONTRACTOR EMAIL: BRENDA@BLACKLIONHVAC.COM 'CONTRACTOR LIC.#REQUIRED)). BLACKLH841L4 ---iCi't"Y"OF EVERETT BUSINESS LIC.#(REQUIRE0),053541 `PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: 425-81.4-3944 BRENDA CONTACTSAIL:Bre blacklionhvac.com AGREEMENT:I hereby certify that I have read and examined this application anci know the same to be true and correct,:Alf 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 1 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 1&27 RCW and 296,200 WAC. City of Everett Official Use Only PERMIT# .40 , NI vitig,„ ilk , g). 2,2.. E 1 OS-L � a m.-,rIAuttlori 4..gent:gtra Date (Revised 9/23/2016) 1;.