820 CADY RD 2016-08-17 (3) - Laserfiche WebLink

*ELECTRICAL PEROL MIT a4 PLICATIC)N CITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettvva.gov/permits PROJECT SITE INFORMATION PROJECT ADDRESS: T'i �� BUILDING AREA(if residential, new construction, remodel,or addition) BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑DUPLEX t9-.MULTI-FAMILY-#OF UNITS: USE OF BUILDING: _ ❑ COMMERCIAL ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: $ 4-LA.— NUMBER OF DEVICES (if low voltage): FIRE ALARM? `Q YES ❑ NO ASSOCIATED BUILDING PERMIT# (if applicable): T4 ^. DESCRIPTION OF WORK: i CONTACT INFORMATION OWNER NAME: N--, -'A f TENANT NAME(If Commercial): �ty OWNER MAILING ADDRESS: STREET STATE V\j ZIP OWNER PHONE:�1,� • L�U • � - OWNER EMAIL: CONTRACTOR NAME: C, U -AJIJ CONTRACTOR ADDRESS: STREET .fir 1 C�l.,(.....C: STATE CONTRACTOR PHONE: j 5. • '1 . ZIP CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED): % CITY OF EVERETT BUSINESS LIC.#(REQUIRED :I• �y PRIMARY CONTACT: E3 OWNER CONTRACTOR El OTHER(Please Specify) ) �� Q CONTACT NAME: CONTACT PHONE: ��Ch CONTACT EMAIL: l AGREEMENT:T hereby certify that/have read and examined this application and know the same to be true and Correct. All Provisions of/aw(and ordinances governing this type of work fat be completed whether specified herein or not. The granting of a permit does not presume(o give authority to violate or cancel the d nof any other state or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property authority perforin the work for which application is made and t comply with the State Contractors Law 18.27 RCW and 296.200 WAC. City of Everett Official Use only FEE ` i PERMIT# uwnerfAuthorized Agent Signature-Ilk Z-- t Date (Revised 10/12/2015)