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1PL <br /> ECTRICAL PERMIT APPLICATION <br /> I�►�> ;-, CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I (E)everetteps@everettwa.gov www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:3c' -5p f=oc✓d//441/ a y )tc' /6e/ <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: lit COMMERCIAL <br /> USE OF BUILDING: <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ S O <br /> NUMBER OF DEVICES(if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: T714 5 I/ G pe 5 e+ e j v,-i of r!f Y ft c (r `j ct,cr e=u0,a,y <br /> ghee-t-V5 v Vq <br /> CONTACT INFORMATION <br /> OWNER NAME: TENANT NAME(If Commercial): 7i4 L2/ /U <br /> OWNER MAILING ADDRESS: STREET <br /> CITY STATE ZIP <br /> OWNER PHONE: OWNER EMAIL: J� <br /> CONTRACTOR NAME:�J I Lt Lam!II,..4;0..55 A)0041,-,L/f'�I� ; <br /> CONTRACTOR ADDRESS: STREET .?!-,.' <br /> / '-2C/' SF /�/'J^ ,S i,. <br /> CITY re i;14-1)" STATE W ZIP/Ng®Si? <br /> CONTRACTOR PHONE: 4/2 3'�6 2( 2 7 3 3 CONTRACTOR EMAIL:)7/1.4-14141 We /14 L Ars e <br /> CONTRACTOR LIC.#(REQUIRED): _112_ N Acy.- J7 CITY OF EVERETT BUSINESS LIC.#(REQUIRED): LA,Ct k LAS <br /> PRIMARY CONTACT: ❑OWNER 9 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME:Tc(e �_ Rvis CONTACT PHONE: Lig - �-Q .?`7 3`� <br /> CONTACT EMAIL: J �' n toe cct L . <br /> 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 <br /> 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 <br /> 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 <br /> comply with the State Contractors Law 18.27 RCW and 296.200 WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> E SOc( - O(02- <br /> 0 en/��horized Agent Signature Date (Revised 9/23/2016) <br />