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

"IPid-°--A ELECTRICAL PERMIT APPLICATION Niiii 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 I www.everettwa.gov/permits PROJECT SITE INFORM ,TION PROJECT ADDRESS i,Z 1,5 ,. i / Li/� 7 Z j 5;'16 `I it ` rl J,3 BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: 4 _.,14-S- A.� ` to ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ S 70 t NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES *0 ASSOCIATED BUILDING PERMIT#(if pplicable): / DESCRIPTION OF WOR : d ty,..._ .nom o.) T-- 8`a A J) Sc .4 i -t ex...--J Te...c.4e-e fx-- e-34.,1 l Lpc --mss lip f ---1-6. c r't. - :. . , CONTACT;INFORMATION . OWNER NAME: A! ,C,:tTENANT NA E(If Commercial): OWNER MAILING ADI ESS: STREET R /5 // s CITY 4� C7�a STATE iJr `te4.,__..,44ZIP ['e,� Q 1 OWNER PHONE: OWNER EMAIL: a CONTRACTOR NAME: / (�"/(c.,-.67 ... . CONTRACTOR ADDRESS: STREET e" 7�:.C/ / a�,'Z <e CITY a ' j . STATE �ZIP �2 ye_ CONTRACTOR PHONE( C(, 3..77 /4. 5W CONTRACTOR EMAIL: e��i-4-7 � --y74,4 4,///Ced4= CONTRACTOR LIC.#(REQUIRED. /{7F:77c_j CITY OF EVERETT BUSINESS LIC.#(REQUIRED)W, Y PRIMARY CONTACT: 0 OWNER ,CONTRACTOR 0 OTHER(Please Specify) CONT CT NAME: CONTACT PHONE: J CONTACT EMAIL: AGREEMENT:T hereby certi at 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 1 am authorized by the owner of this property to perform the work for which application is made and 1 comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use Only FEE ' C—.. k.Ts°4 -k 2 2- PERMIT# E 233 rSCC Owne •uthorize gent Signature Date (Revised 10/12/2015)