2415 11TH ST 2019-08-13 - Laserfiche WebLink

- LECTRIICAL PERNIQT A LIICAT O N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 J FAX 425-257-8857 (E) everetteps@everettwa.gov j www.everettwa.gov/permits • PROJECT SITE INFO•,MATQO PROJECT ADDRESS:a l•1!/5 lT 5 �`,U BUILDING AREA(if residential,new construction,remodel, or addition) SF BUILDING TYPE: ❑SFR-DETACHED 0 SFR ATTACHED 0 DUPLEX :' MULTI-FAMILY-11 OF UNITS: g 0 COMMERCIAL USE OF BUILDING: A . A 3.4L_____ I ECTRICAL APPLL, ATS•;N INF:RMATa.0N CONTRACT PRICE OF WORK: ' • • NUMBER OF DEVICES (if Io .'voltage):. FIRE ALARM? 0 YE ANO ASSOCIATED BUILDING PE'.,iIT# if i able): DESCRIPTION OF WORK: `e:1�..) (e €471c:541- ✓1 �'f 4, f 4.7 —7 0, 6:. ?� CONTACT INFORMATION • OWNER NAME: rivrA", r� eJ� A �`� TENANT NAME(If Commercial): OWNER MAILING ADDR6-SS: STREET 1 \ R CITY STT TE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME:�yv,�`JJ T t`q r4 �� s � �C CONTRACTOR ADDRESS: ssTREE ` JJ(� CAAAA XY1C) CnY( .4/1QY, ��5 STATE ZIPCN a_53 7- CONTRACTOR PHONE: 373 54:, CONTRACTOR EMAIL: rl v (_ l CONTRACTOR LIC.#(REQUIRED):`jw TiL'/74L-7) CITY OF EVERETT BUSINESS LIC.#(REQUIRED): (2/97,3 PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) • CONTACT NAME: CONTACT PHONE: 3g 38 7 l CONTACT EMAIL: •: 2 c � � � 1;L41 AGREEMENT:T hereby certify that I have read and examined this application and know the same to be true and correct Ail 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 I comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEEE r PERMIT# 22 -.rized Agent Signature Dat (Revised 10/12/2015)