1019 112TH ST SW 2019-09-25 - Laserfiche WebLink

kLECTRICAL PERMIT AFVLICATION iiio,r..7,_A Nimiwi 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 SITE INFORMATION PROJECT ADDRESS: D67/Y `/a ' s' 50j BUILDING AREA(if residential,new construction,remodel,or addition) klil4 SF • BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: .- IL-OMMERCIAL USE OF BUILDING: t� - Cy."ry 1 ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ Y,®CD a „ NUMBER OF DEVICES(if low voltage): °vV. FIRE ALARM? 0 YES di-NO ASSOCIATED BUILDING PERMIT#(if applicable): _p DESCRIPTION OF WORK: c.2 / kurv'G /02,- L/ ZN7 n /1-/ / CONTACT INFORMATION. OWNER NAME: CosAlloy id/V 1 i i—m C1 Mule ci .V TENANT NAME(If Commercial): yi OWNER MAILING ADDRESS: STREET ggj O?.y-6V G!l< V'�`�"�"lQ (y� yy [.t CITY Ev&�e!l STATE NA ZIP / /� 208 OWNER PHONE: P5= 7g97 V OWNER EMAIL: NA CONTRACTOR NAME: fi C --fie C_._. CONTRACTOR ADDRESS: STREET iyZ3 04Pr--43- 04v,C Jn CITY . E V ‘JJl!7 STATE V1 /ZII�P�/ Sc/ /� CONTRACTOR PHONE: 9Z3-:2' 76 0$ CONTRACTOR EMAIL: W lav-k uti's4CJice 4,0-1e4-Ca CONTRACTOR LIC.#(REQUIRED): A,SSE?J 71l_e CITY OF EVERETT BUSINESS LIC.#(REQUIRED): /60: PRIMARY CONTACT: 0 OWNER AsfCONTRACTOR 0 OTHER(Please Specify) �N,�*~�.„...,�...„,n,.„.,�._..�,.,...�_.�..M................�„„�,......�,.„,,,..,..,..�.. CONTACT , S CONTACT PHONE: ti z - 2 6 g- 703 . 7C 1N� CONTACT EMAIL: (,)i CfmIU‘r$6 ® II✓o t'ice C'O!/)/! AGREEMENT:T 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 FEE # 1 62, E PERMIT# I.It/it / &/fli S' E 1 (60(0-Oil?, • ner/Authoriz-d Ag: Si. attire Date (Revised 10/12/2015)