129 75TH ST SW 2019-08-13 - Laserfiche WebLink

R ECTRICAL PERMIT APPLICATION "Ii.t4s.,----.4CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov l www.everettwa.gov/permits PROJECT SITE.INFORVMATION PROJECT ADDRESS: 129 75th Street SW BUILDING AREA(if residential,new construction,remodel,or addition)Remodel SF "71 boo s4. Pr BUILDING TYPE: 0 SFR-DETACHED ®SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INIFOIATION, ! -- CONTRACT PRICE OF WORK:$ 4000.00 NUMBER OF DEVICES(if low voltage): FIRE ALARM? 0 YES IZI NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: Kitchen and Master Bath Remodel CONTACT INFORMATION OWNER NAME: TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE: OWNER EMAIL: CONTRACTOR NAME: Main Street Electric CONTRACTOR ADDRESS: STREET PO Box 1856 CITY Edmonds STATE WA Z,P 98020 CONTRACTOR PHONE: 425.775.6246 CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): MAINSEIO2I DK CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 054879 PRIMARY CONTACT: ❑OWNER VI CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: CONTACT EMAIL: AGREEMENT I 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!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 PERMIT# ��i��- •�--�.= E i(60(o- )but OwnerlAuth' /,gent Signatur- �i Date (Revised 9/23/2016)