2606 100TH ST SE 2019-08-20 - Laserfiche WebLink

ELECTRICAL PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8310 FAX 425-257-B857 (E)everetteps@everettwa.gov www.everettwa.gov/permits PROJECT. tT.e;tN FORMATIO l+i PROJECT ADDRESS: 2(4)0 62 100" 5.1-" _ BUILDING AREA(if residential, new construction, remodel,or addition) SF BUILDING TYPE: SFR-DETACHED 0 SFR-ATTACHED ❑ DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL USE OF BUILDING: EL1RI CAv4# i 'L. , t't Ni i M "'`It N CONTRACT PRICE OF WORK: $ 2__.5 NUMBER OF DEVICES (if low voitaUe): FIRE ALARM? ❑ YES JNO ASSOCIATED BUILDING PERMIT#(if applicable): _ DESCRIPTION.QF_WORK: 1ns , -- _.. . , ;ctiNfrakocifirottmAttlok OWNER NAME: CA0t r��5 ! Buro¢„,5 TENANT NAME(If Commercial): OWNER MAILING ADDRESS STREET , " CRY aJL STATE ZIP 2L:+ OWNER PHONE: *J 44 2,9 * OWNER EMAIL: CONTRACTOR NAME: AS2-0-110 CONTRACTOR ADDRESS: STREET WO ad .► . a CITY STATE ^''C- ZIP Ci 2v CONTRACTOR PHONE: Lt sl ci r CONTRACTOR EMAIL: _..__ CONTRACTUR LIC�(�tLc�ttiizedr� �� VYI i1''1W ldel CITY OF EVERETT BUSINESS #(RECIUIRECJ): 1 1VQ _ PRIMARY CONTACT: ❑OWNER ?A CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: )�(,� CONTACT PHONE: L 35q D� J L,oie, CONTACT EMAIL: "'j ns , AGREEMENT..I hereby certify that 1 have read end examined this application and know the same '}e true end correct. All provisions off lawsRAC •Tgoverning this type of work wilt 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 stale or local law regulating construction or the performance of construction. That 1 am authorized by the owner of(his property to perform(he 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 u 6.1s l c' E ??0 �J dwnerlAu(harized Agent Signature I Dale (Revised 9/23/2016)