10921 19TH AVE SE 2019-06-11 - Laserfiche WebLink

LLECTRQCAL PERMIT Afi II LICATII©N 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 J www.everettwa.gov/permits PR'�JEOT SI 'P.INSP>R A*ION PROJECT ADDRESS: /Ogjj .. /9/9"f tAe 45— 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: OMMERCiAL USE OF BUILDING: /, veh , _ f.�, ELECTRICAL PPUiCATiON iNFORMON CONTRACT PRICE OF WORK:$ /+0 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES Cl NO ASSOCIATED BUILDING PERMIT#(if applicable): / ` DESCRIPTION OF WORK: /aka) Aja,/Gert' 7 3 4C i1Y�o�rlgr /�,34ftArH� Oh O '�� ,f e,2. Pita re_` /t Cerate (11k,, r�,y) d-box O . .. ... .... ...:.: . .. :,. .. ,_ : . ...� -:: °.: � :; �: • ...,:ONTACT;INF'ORMATiON- OWNER NAME: W TENANT NAME(if Commercial): OWNER MAILING ADDRESS: STREET crry STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: S/J'f LT _ref'(,flak/ Lt_, CONTRACTOR ADDRESS: STREET /Gla 7 nmrt�t (,/y D 2 ((Ho(Q I' l CITY STATE h/4 ZIP CONTRACTOR PHONE: 2,g3 721_ CONTRACTOR EMAIL: CONTRACTOR LiC.#(REQUIRED):�//76sare 13, _ x CITY OF EVERETT BUSINESS L1C.#(REQUIRED)Ltg4-11 PRIMARY CONTACT: 0 OWNER CONTRACTOR I'' OTHER(Please Specify) al S' e, CONTACT NAME: CONTACT PHONE: 330 ra S/(7 41V. >) A/ CONTACT EMAIL: Q u s AGREEMENT:T hereby certify that I 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 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 FEE PERMIT# .41 z�_/, L 02- 02-k Owner/.uthorized Agent Signature Date (Revised 10/12/2015)