9931 19TH AVE SE 2019-06-11 - Laserfiche WebLink

P�--� ECTRICAL PERMIT AP (CATION I�►�� - 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 SITE. INFORMATION PROJECT ADDRESS: 'v \T ` 19-1 f ��-�_- %. 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: EL"ECTRICAL APPLICATION INF .RMATION CONTRACT PRICE OF WORK: $ J I-C)© -- NUMBER OF DEVICES (if low voltage):/ FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: CA..CLlam_ t tcAN, 1� J � CONTACT.INFORMATION OWNER NAME: 9ftjiut,4. TEN NT NAME(If Commercial): h j fk OWNER MAILING ADDRES : STREET 4/9 74 Pr 4/‹.- CITv / ZL�,,,.O '- -!r STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: /7 Ly C-A.) f/S CONTRACTOR ADDRESS: STREET 6CJ/ ®K 9' CITY ( STATE it " ZIP ( q1' CONTRACTOR PHONE: 2-3` GIS I r3 I CONTRACTOR EMAIL: ( �� (y` L 4 111 + *' �o CITY OF EVERETT BUSINESS LIC.#(REQUIRED): '�i CONTRACTOR LIC.#(REQUIRED) (4_��L..L � �G �� 05, 16-1 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ` CONTACT PHONE: 3 - 2? r O ©f PCkik- Gt-v /-(-1-46) CONTACT EMAIL: ck ,Q�,ce i4 AGREEMENT.'I hereby certify that I have read and examined this application and know the same to be trend correct. All provisions of laws 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# .....„,„0011110111111111111111111111111111111171111.":,-: ._._ E 0 3--- 1�11, Owner/Authorized Agent Signature Date (Revised 9/23/2016)