405 SE EVERETT MALL WAY 2019-09-05

LECTRICAL PERMIT APRICATIIIN: ,- 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: ii05 5 t ti/e-r ,- Mall V y 9 g a o - BUILDING AREA(if residential,new construction, remodel, or addition) SF BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING: ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK:$ 27, Dap NUMBER OF DEVICES(if low voltage): Z1'? FIRE ALARM? 0 YES JXNO ASSOCIATED BUILDING PERMIT#(if applicable): 3j I got-ooc DESCRIPTION OF WORK: Relm-)00ket LeD3 Vd i±c�c�e. Only I€ Ie corn trym- m(AYES I i-ers C'un � (.� bre- �s .-hores CONTACT INFORMATION OWNER NAME: I Qr9e-1•- COnpurcrii r1 TENANT NAME(If Commercial): OWNER MAILING ADDRESS: sTREEr L+ /S 5E /p rp . fl10 p q CITY Rte re# STATE Lk / a qp?V g OWNER PHONE: OWNER EMAIL: N CONTRACTOR NAME: kh Ser ices LLC CONTRACTOR ADDRESS: STREET 20.-2-7c M 594.6 Ave ( 1 S CITY I'en dot(,€ STATE 3 rr a ZIP gS CONTRACTOR PHONE: S oZ24g-c .33 z -j CONTRACTOR EMAIL: cps W�J+7 S C. CONTRACTOR LIC.#(REQUIRED): -7_04IJNS9:0 CO CITY OF EVERETT BUSINESS LIC.#(REQUIRED): J?J PRIMARY CONTACT: 0 OWNER 'ZONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: LRC)-:---7c4-7- g70 CONTACT EMAIL: ac.Cc/V-) 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 l am 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 itis, „ft.__ PERM1T#�n Owner/Authorized Agent Signature Date (Revised 10/1212015)