6315 CYPRESS ST 2019-06-24 - Laserfiche WebLink

!LECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-88571 (E)everetteps@everettwa.gov J www.everettwa.gov/permits PROJECT SITE INFORMATION . PROJECT ADDRESS: (g315- r f f' 51- BUILDING AREA(if residential,new construction, remodel, ' addition /00 SF BUILDING TYPE: I'SFR-DETACHED 0 SFR-ATTACHED • P UPLEX ❑ MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ t NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: ("L (Q (\tet$.u/ Cams 0-Ga / old 8-w 1 t 4 r- rsl_e, e ) CONTACT INFORMATION OWNER NAME: The-615 15 Can;f f,tC 10 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET PO B vx 10t/ cnY b/ V, , ' STATE ZIP ?g,�.0.�j -I OWNER PHONE: -V n (p�j I OWNER EMAIL: MI a�t e 0 n 6,) S/1 CONTRACTOR NAME: �kL ckv.4 5 UQ d /k LLA- CONTRACTOR ADDRESS: STREET -5)1 Y 9M f-✓E CITY Vim"I__ f Ptite STATE W/1- ZIP 70f j CONTRACTOR PHONE: 7,5 n7 7 Li L(> CONTRACTOR EMAIL: ,Q G•y�de-cCen4.e yirpt,„/ CONTRACTOR LIC.#(REQUIRED): c,L 1„4- 0oTY OF VE _..�,..a�.��r..�...��.�.m.n._..._�_u..,..r_,.,��......y. _:.a..,..,.S..�..,w.. � .._,.� CIEVERETT BUSINESS LIC.#(REQUIRED):�.: .._...w...µ:...�r.. ..._ _n......kw.w�.n�...y.r�,.....�..�_..��µw�.�.....�...._... :..r.._._.,a. PRIMARY CONTACT: 0 OWNER PaONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: /(2,5- 32_7 7 till?n 5 Va.4-ka,r CONTACT EMAIL:/,,ct" , .CA.4!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 anfordinances 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 98.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE 16 . PERMIT# E 12)64-DWI Owner/Authorized Agent Signature Date (Revised 10/12/2015)