1919 112TH ST SW 2019-08-14 - Laserfiche WebLink

‘041V 11 CALI fb TRICAL PERMIT P T#_1 # CITY OF EVERETT PERMIT SERVICES te P Li 3200 C. 0° " ,. IP C ,WA 98201 (P)425-257-8810 I FAX 425-257-885 I ( )everetteps�3a everettwa.gov everettwagov permits PROJECT SITE IRIAT I� IOI PROJECT ADDREs5: f t r - i BUILDING AREA(if residential,new construction,remodel,or addition) SF � BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED CI DUPLEX D MULTI-FAMILY-#OF UNITS COMMERCIAL USE OF BUILDING: rrt.a«y ,9" V r .t"'S".,.y /- , ELECTRICAL APPLICATION:INFORMATION CONTRACT PRICE OF WORK:$ 40" .e. , ' — : e-',e:ee 74 Ale e,,#`•-` 'e.. NUMBER OF oeviCES(if low voltage):- (r (Ai/ - FIIE ALARM? 0 YES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable):At 111 ‘. .01,- 2_ DESCRIPTION OF WORK: t .CONTACT INFORMATION. OWNER NAME: j c 57 11 , ', . y c NANT NAME(If Commercial): 4- $e.. a.5^"` .r 7 OWNER MAILING ADDRESS: MEET [0/ ", 57 A crrY. t'1,1, ......i ...5 a, s_-°-' sTArt:..._ ._ Zlf'. 1 `7.} 96'.. . OWNER PHONE: 4//4 OWNER EMAIL: it/74 'CONTRACTOR NAME: .M e-...,,,•44 F 7... ." .. yf76--1-4 ..5.- CONTRACTOR • - CONTRACTOR ADDRESS: STREET /ef /41 CITY d ei t?, :, STATE ZIP , 5 CON •CTOR PHONE: .sT W / CONTRACTOR EMAIL:�y • er ,ca 9 r,+r c"oi-r .5` 7",-/-s-.<` CONTRACTOR LIC #(REQUIRED C C G� - r` CITY t}F EVERETT BUSINESS LIC #(REG2UI :I) PRIMARY CONTACT: CI OWNER CONTRACTOR' 0 OTHER(Please Specify) NTACT NAME: CONTACT PHONE: (25-9 5zc.? — 6/77 ' al:-.46-4f-'77:i4 -, a 4 CONTACT EMAIL: e',,,, „,'",” e „J.?, ,.. ,,,„4 , ,i ,: g`''`ar q, c- ;” AGREEMENT Thereby certify#hat t have read and examined this application and know the same to be true end 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 of cancel the provisions of any other slate or boat law regulating construction or the performance of construction,. That I am authorized by the owner of this property to perform the work for which application is made and f comply with the State Contractors Law 18.27 RCW and 296 200 WAC. City of Everett Official Use Only FEE ( / / . PERMIT# ,- l ( 2. -01g t 4 riiaer/Authorized Agent Signature Date (Revised•10/12/2015)