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OLT dikCTRICAL PERMIT AP_(CATION <br /> 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 I www.everettwa.gov/permits <br /> '! PROJECT SITE INFORMATION <br /> PROJECT ADDRESS: / 1 5" 8k1(-CV JC t 144 y CVC.rc if, WA 98 248 <br /> BUILDING AREA(if residential, new construction,remodel,or addition) '10,600 SF �/ <br /> BUILDING TYPE: 0 SFR-DETACHED 0 SFR-ATTACHED_� 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: IJ COMMERCIAL <br /> USE OF BUILDING: Elen�elt�-avt) Sckoo t C s/i YGi Lake—, <br /> ELECTRICAL APPLICATION INFORMATION: <br /> CONTRACT PRICE OF WORK: $ 3000(0.00 —15 00, ✓ 2_ <br /> .qQQ, <br /> NUMBER OF DEVICES (if low voltage): C <br /> FIRE ALARM? 0 YES 19/NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): EI SO S- I 17 <br /> DESCRIPTION OF WORK: Pot( ,' y.. instal( Cs) Com. re. ,l'. ) (z) mes icr S fzf-i0'tt-cs <br /> i) V 14-o i rid trc4At- / (i) I CCQ$S Cokt1 o f I artfir?-1'�- - C <br /> `''T�iI�@',(A'm FiLr) <br /> CoottAtf INFORMATION <br /> OWNER NAME: Ever kf cCC O( Di 5fC.-" TENANT NAME(If Commercial): ci/Yrf/ --&e Elei.ept f-dv <br /> OWNER MAILING ADDRESS: STREET 3900 13v0aiW <br /> CITY Eve i t-.l STATE (AJA ZIP I (J G•® I <br /> OWNER PHONE: 42g -1325C 4000 OWNER EMAIL: <br /> CONTRACTOR NAME: NelSO71/4- E.tr_.C.,fric_, <br /> CONTRACTOR ADDRESS: STREET b 2.O S' vt e. kvt. IJ — S K 20 1 <br /> CITY Se.e,„ff1 STATE W ZIP 12) 103 <br /> CONTRACTOR PHONE: xi, 23-4S2S CONTRACTOR EMAIL: <br /> CONTRACTOR LIC.#(REQUIRED): NELSoi I132C Z CITY OF EVERETT BUSINESS LIC.#(REQUIRED):009 410 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR PrOTHER(Please Specify) r W)tee( itite-KdA7 �7 <br /> CONTACT NAME: M CONTACT PHONE: 2 6-70(- 43 16 <br /> M( � CO"! CONTACT EMAIL: yv(t?"ery 0 NeASOII.G(C.C.00 AN.... <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 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 /> City of Everett Official Use Only <br /> PERMIT# <br /> 8,8 - f s E I q) 0 -051%) <br /> Owner/Authorized Agent Signature Date (Revised 9/23/2016) <br />