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4477- ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, <br /> 98201 <br /> P)425-257-8810 I FAX 425-257-8857 (E)) e e etteps©everetttwa.govA <br /> www.everettwa. ov/ ermi <br /> 9 p is <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: 2315 74TH ST SE <br /> BUILDING AREA(if residential,new construction, remodel,or addition) SF <br /> BUILDING TYPE: 21 SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: RESIDENTIAL <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK:$ 1000.00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES 0 NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: 200 AMP PANEL REPLACEMENT <br /> CONTACT INFORMATION <br /> OWNER NAME:CHRIS TOWEY <br /> TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: STREET 2315 74TH ST SE <br /> EVERETT <br /> STATE WA ZIP 98203 <br /> OWNER PHONE: 206-914-2645 <br /> +OWNER EMAIL: <br /> CONTRACTOR NAME: BLACK LION HVAC <br /> CONTRACTOR ADDRESS: STREET 11001 118TH PL NE <br /> CITY KIRKLAND 98033 <br /> CONTRACTOR STATE WA <br /> CONTRACTOR PHONE:425-814-3944 ]CONTRACTOR EMAIL: BRENDA@BLACKLIONHVAC.COM <br /> CONTRACTOR LIC.#(REQUIRED): BLACKLH873QQ (CITY OF EVERETT BUSINESS LIC.#(REQUIRED):053541 <br /> PRIMARY CON"ACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> BRENDA 425-814-3944 <br /> CONTACT EMAIL:BRENDA@BLACKLIONHVAC.COM <br /> AGREEMENT:I hereby certify that I have road 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 I am 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 /> -- <br /> CityCity of Everett Official Use Only <br /> r <br /> ` b PERMIT# <br /> 4 (1) " <br /> Ownat, orize 'lgent t gnature � <br /> hi- <br /> E ,7)0(,), <br /> Date <br /> (Revised 9/23/2016) <br />