214 77TH PL SW 2019-08-14 - Laserfiche WebLink

git ECTRICAL PERMIT APMICATION h►' 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 vwuw.everettwa.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: 2>'f 7 7 L4 P//c e S/,J BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0 SFR-DETACHED L"41 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY #OF UNITS: 0 COMMERCIAL USE OF BUILDING: APPLIC ION INFORMATION CONTRACT PRICE OF WO' .$ Li O 0 NUMBER OF DEVICES if low voltage): FIRE ALARM? • s: ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: C .404/61 L SCC / (14 L S'5/ ig/f C E Ta '1v Lly A9A4p 4./6-fig MAM/ 4 A6 3 6/Rac i r4 r )4/14i Ly /q-b a/I4 o Ayg/Z Afro vd/i9;iE. CONTACT IINFORMATIiON OWNER NAME: Y{f/9.e I< -4- S%c/-17I t7�► /�liyG�el1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: STREET f/ 7.7IA /7/a c e. t-t) CITY Cli.et•-.G .4 STATE IVZIP 9f. .o3 OWNER PHONE: 2 5 3- 65/_ V6-96OWNER EMAIL: m '3 m S I'7, C v"-, CONTRACTOR NAME: CONTRACTOR ADDRESS: STREET CITY STATE ZIP CONTRACTOR PHONE: CONTRACTOR EMAIL: CONTRACTOR UC.#(REQUIRED): ` CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 4 PRIMARY CONTACT: AOWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: ng K 1/4 y .4J CONTACT PHONE: 5//3 - G, -,i 9. —9( CONTACT EMAIL: y3 /-rr 5f(C C O 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 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# - �� ,: �/ , E 1 `QO2 Owner/Authorized A!='t Si " ure Date (Revised 9/23/2016)