12800 19TH AVE SE 2019-06-11 - Laserfiche WebLink

ELECTRICAL PERMIT A WLIC A.TION vitifIi►' CITY OF EVERETT PERMIT SERVICES .._, 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 J (E) everetteps@everettwa.gov J www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: / ;;�2o /(i /''Ave 5E BUILDING AREA(if residential,new construction,remodel, or addition) 7 -"! SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: •COMMERCIAL USE OF BUILDING: AdP/ f - / s r-is/s,f ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ g1 91,2 a' • NUMBER OF DEVICES(if low voltage):• , FIRE ALARM? ❑YES I 'NO ASSOCIATED BUILDING PERMIT#(if applicable : DEJSCRIP))TION OF WORK: 5e/ilerch/,20 �moo,,F,1yi Q '1i 9" ... qrP� gPUSP i,31 //c- // - CONTACT INFORIVIATION .. OWNER NAME: q�jv i C,{, 74,--: ///77 r�/ TENANT NAME(If Commercial): f� a� t i�� _n ,!- (412 OWNER MAILING ADDRESS: STREET J a / 7� (/,- � crrY IVC'✓ -ff STATE ZIP��a`(('S OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: / ,,�� F/�/� Y 7!, . _. /� 5, -7 S , ti /l CONTRACTOR ADDRESS. v STREET /O0 J/ �Y�,� � ,S,?�. (l/�,�(J CITY .E,,,,?,--N STATE[A/✓ zIP /j e5?, CONTRACTOR PHONE.•4 f 1eSP X79 z-,2... CONTRACTOR EMAIL: ' CONTRACTOR LIC.#(REQUI ED) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): Ll ORI 5 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /x/25 5.c3 ysy7 . CONTACT EMAIL: ��v/A g >e / 6. )•r moi'?,, AGREEMENT:T hereby certify that 1 have read and examined this application and know the same to be true and correct All provisionsof 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 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE PERMIT# , - iliVe,- Owner/ •• !zed ••gent Signature Date (Revised 10/12/2015)