1228 GRAND AVE 2022-02-08 - Laserfiche WebLink

ECTRICAL PERMIT AP%ICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT WA 98201 (P) 425-257-8810 j FAX 425-257-8857 j (E) evere#tePS@everetiwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: I d % BUILDING AREA (if residential, new construction, remodel, or addition) LIQC� SF i3U1LDfNG TYPE: FR-DETACHED O SFR ATTACHED ❑ DUPLEX ❑ MULTI -FAMILY-# OF UNITS_ a COMMERCIAL USE OF BUILDING; ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ -7 ' 00 . c o1 NUMBER OF DEVICES if IOW v01t2e : FIRE ALARM? Ct YES © NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: o r r f CONTACT INFORMATION OWNER NAME: TENANT NAME (If Commercial): OWNER MAILING ADDRESS: smeu <61 C-1,ceyNd Auec CnY Y sTATE A zip OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: r-N I V CONTRACTOR ADDRESS: srReu A SA, V Crrr Al Qx v. +i STATE 1tjA iR 70 CONTRACTOR PHONE: 3(---C (0 S 3 9 L4 CONTRACTOR EMAIL: CL-mmncict, e' L'jo4rv,. (--- m CONTRACTOR LIC. #(REQUIRED): G A?-v-t E, y '7 G ,T CITY OF EVERETT BUSINESS LIC. #(REQUIRED): 0,3916 PRIMARY CONTACT: II OWNER O CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: -o^saur\ o, 14c:0va mi ACREFrLtGntF• Thu.ah....e.E:t.n..c r L_.__ �_1 __ . _ __ _ _ CONTACT PHONE: 3GQ (05 3 4q 35 ICONTACTEML*- arnc--r-, ; . (--' 9c-wv' t7 e—n+ vna++m�cu uua oNpu�aupn an0 KnOYY Ule same f0 h@ flue and cOlrecL Aff provisions of haws and ord/nances goveming this type of vrork will be completed whatherspecified herein ornoL The granting ofa permit does not presume to give authadty to violate orcencel the provkkm ofany othersiate or local taw regulating consirucfion or the performance of consf►uciion That 1 am aufhomedby the Owner of Iles properly to perform The work for which app6catkm is made and I comply with the Stafe Contractors Law 19.27 RCW and 29a.200 WAC. Owner/Authorized Agent Signature L'1/3) i -7 Date Cify of Evereff Oficfal Use Only FEE 0 PERMIT # E 11 (Revised 10/i22015)