3012 23RD ST 2019-06-12 - Laserfiche WebLink

0:77 ELECTRICAL PERMIT APPLICATION 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: S G i 3� J`'-I +r e c- E.V C r-et 1 GJ f1 98 C7 I BUILDING AREA(if residential,si/ new construction,remodel,or addition) SF BUILDING TYPE: hd'SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: (P_s 4 � C„Ce ELECTRICAL APPLICATION.,INFORMATION CONTRACT PRICE OF WORK:$ hlA NUMBER OF DEVICES(If low voltage):: � FIRE ALARM? ❑YES 'ET NO ASSOCIATED BUILDING PERMIT#(if applicable): t DESCRIPTION OF WORK: .i,h35-l-n 44 E1�c�C-V, --'i ) 0 i vY)( 1‘, { ~ @OA)Le.v—f c.Q4C') L: raoLI e$,1-e,id o CONTACT INFORMATION OWNER NAME: �e___-"t 0 16P4) pj cTENANT � NAME Of Commercial): OWNER MAILING ADDRESS: STREET 3t�i a e �� ` "1" C..) ] �1 any 4�e-H"E� STATE 14 IJP l(7.(l 0O) OWNER PHONE: OWNER EMAIL: r r r CONTRACTOR NAME: /V(r r 4-10 ct!? rt Z G.0` ',— 5 CONTRACTOR ADDRESS: STREET ' t 4o t� r t.;y"h A(� , (: ��r ) S t s � t-z- 14 p /' any 1!1.)!l�C..t'c p STATE i (Q+ ZIP c18 0 3 W CONTRACTOR PHONE:4:15-774 r 7o 0c) (CONTRACTOR EMAIL:r r e.LLr---,,,`c F,� ‘re�„i-P;.-y6,1-t. LIL G v- ,L, CONTRACTOR LIC.#(REQUIRED):NIJR606 (.,�39C) Q C CITY OF EVERETT BUSINESS L1C.#(REQUIRED):0.5/.5 34. cc-147 PRIMARY CONTACT: a OWNER LWCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: E6 cam.{�o5S CONTACT PHONE: ;.1/44a5--7 7' -- TCI 0 CONTACT EMAIL: SAmI 03 C co.;{-rcaC )V' e-vY\a,I L AGREEMENT::!hereby certify that I have read and examined this application and know the same to be true and correct. AA 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 l am authorized by the owner of this property to perform the work for which application is made and! comply with the State Contractors Law 18.27 RCW and 298.200 WAC. City of Everett Official Use Only PERMIT# ..QC16X-Ii9c:;+a01 ��Y.. iN.3:ev\J. 8- 7- 5-1 E ��o - o((O Owner/Authorized AgentSignature l Date (Revised 9123/2016)