4721 BLACK FOREST LN 2019-07-12 - Laserfiche WebLink

4177- ELECTRICAL PERMIT APPLICATION 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 www.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS:4721 Black Forest Ln BUILDING AREA(if residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑✓SFR-DETACHED ❑SFR-ATTACHED ❑ DUPLEX ❑MULTI-FAMILY-#OF UNITS: ❑COMMERCIAL USE OF BUILDING: hL *CTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $630 NUMBER OF DEVICES (if low voltage): FIRE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT# (if applicable): DESCRIPTION OF WORK: 1 circuit for furnace CONTACT INFORMATION OWNER NAME: Scott Hardy TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREET4721 Black Forest Ln CITY Everett STATE WA zip 98203 OWNER PHONE:425-530-6227 OWNER EMAIL:ScjOttanddena@comcast.net CONTRACTOR NAME:Washington Energy Services CONTRACTOR ADDRESS: STREET 3909 196th St SW CITY Lynnwood STATE WA ZIP 98036 CONTRACTOR PHONE:206-378-6648 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):WASHIES854NG CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 054773 PRIMARY CONTACT: 0 OWNER CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:206-378-6648 Nikki Hyett-Schnell CONTACT EMAIL:Nhyett-Schnell@washingtonenergy.com 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 I am 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,# /VP) I'1 E I 2- 1 2 10/09/2018 Owner/Authorized Agent Signature Date (Revised 10/12/2015)