716 75TH ST SE 2019-08-13 - Laserfiche WebLink

s 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 I www.everettwa.gov/permits PROJECT ADDRESS. 716 75TH ST SE BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 21 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING; RESIDENTIAL '' ,. * e `.T!I ,cAi, f►P0110.'A1 J N IINF+C MkTIOI4 .'li . ‘tik CONTRACT PRICE OF WORK:$ 4500 NUMBER OF DEVICES(if low voltag .FIRE ALARM? ❑YES Q NO CIATED BUILDING:.PERMIT#(If'aPPUORI Ie) DESCRIPTION OF WORK: NC ,_v OWNER NAME:ALY TOURS TENANT NAME(If.Commercial). OWNER MAILING ADDRESS: STREET 716 75TH ST cnv EVERETT STATE WA ZIP 98203 OWNER PHONE: 425-595-0256 OWNER EMAIL* W CONTRACTOR NAME: BLACK LION HVAC ONTRACTOR ADDRESS: STREET 11001 118TH PL NE cny KIRKLAND STATE WA ZIP 98052 CONTRACTOR PHONE:425-814-3944 'CONTRACTOR EMAIL: BRENDA@BLACKLIONHVAC.COM .NTRACToR LIC tkEQIJ1REDy BLACKLH873QQ cny OF EVERETT BUSINESS LIC <.REQUIRED',053541 PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR El OTHER(Please Specify) CONTACT NAME. CONTACT PHONE: 425-814-3944 BRENDA CONTACT EMAIL: .BRENDA@BLACKLIONHVAC.COM AGREEMENT:I hereby certify that i have read and examined this application and know the same to be true and corrects: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 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 18.27 RCW and 296.200 WAC. City of Everett Official Use Only PERMIT# 1111. s €Wrier ' ' d A tur. tDate (Revised 9/23/2016) ' ,