1000 SE EVERETT MALL WAY TERRA STAFFING 2019-09-05

OLT ELECTRICAL PERMIT Ii A PUC T 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: 16(5n 5 E__ v c- / 4e, 4ITNc� / BUILDING AREA(if residential, new construction, remodel, or addition) O 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: $ 2 c> NUMBER OF DEVICES (if low voltage): 2 5 FIRE ALARM? 0 YES Cl NO ASSOCIATED BUILDING PERMIT# (if applicable): 41/1/41± � DESCRIPTION OF WORK: Co fig v( Iccirlo Lel to(.Z e� S-V {1r/4±1c // CONTACTeINFORMATION (}. OWNER NAME:i -1 1 l cl iia?�—�ve.,rt 1L' /I0( t4.41-6 TENANT NAME[ (If Commercial)7T c c'i -� 'p S�'T47,+z0i OWNER MAILING ADDRESS: STREET Ui L>/ I (.), res•? S�' 41 /� fin/ ^ CJ CITY a l�.et t 6 I-e STATE 01. D /ZIP 92/L'/ OWNER PHONE: OWNER EMAIL:36." ! r5.?±4eck43(1cs t-ee5 d (/Q ✓toe. ,0 c`-h CONTRACTOR NAME: S O t7?-? r SL -0 c: A-1 d/ ,'.r,S 1 CONTRACTOR ADDRESS: STREET //4)/Z/ Cy'2 r �Z t� /t1(7' 2- CITY E STATE 04 ZIP(13 CONTRACTOR PHONE:'25 370.- ( ?(/'Z CONTRACTOR EMAIL: CONTRACTOR LIC.#(REQUIRED):Cr r." �+ I E L' CITY OF EVERETT BUSINESS LIC.#(REQUIRED): PRIMARY CONTACT: OWNER 0 CONTRACTOR 0 OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: el 2 G 7Q PoLC CONTACT EMAI L:SD eYte r5 e c.1-‘✓LO/o 1-Q,5 yecLrcvo 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 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 I 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 PERMIT# /-9-:LCV11 azl2, ,) /02z - ra E Yr061,b— fl l Owner/Authorized Agent Signature Date (Revised 9/23/2016)