1118 80TH ST SW BASE FILE 2020-02-25

ELECTRICAL PERMIT APPLICATION Imo,,gititCITY OF EVERETT PERMIT SERVICES 3200 CEDAR STREET, EVERETT, WA 98201 (P)425-257-8810 I FAX 425-257-8857 1 (E)everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SI E INFORMATION �' , PROJECT ADDRESS:V\\C' %i h -• '5\r4 i -X( �'�A �� BUILDING AREA(if residential,new construction,remodel,or addition) SF BUILDING TYPE: 0�SFRR--DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: COMMERCIAL USE OF BUILDING:t \1MP�CC.,1rA .: ELtGTRICAL APPLICATION INFORM' iT,ION CONTRACT PRICE OF WORK: $.`'[1 2. `2j 11) NUMBER OF DEVICES(if low voltage): k FIRE ALARM? AYES 0 NO ASSOCIATED BUILDING PERMIT#(if applicable): DESCRIPTION OF WORK: \f\tA fe' .(>-C!(Nct- j"FOCI 4CX 'V('-(.( .2-\k--k 53' vo, CONTACr INFORMATION OWNER NAME: e, fJ TENANT NAME(If Commercial): n I Cx OWNER MAILING ADDRESS: STREET AM a)A 5k-. l'\ i ) CITY VV e. STATE *Lk ZIP C OWNER PHONE(\Y�.� RLI)-- tt-V OWNER EMAIL: . \(\ . c ,O ,cpm V CONTRACTOR NAME: (` u,(`gA i,h)(\ 'b'-e. A(l kt-X'c-`j CONTRACTOR ADDRESS: STREET VIW3 ice` }\fe .5 CITY STATE YV4. ZIP4613,4- CONTRACTOR PHONE )t lq-.)--3' 442 CONTRACTOR EMAIL:q.t./ -t lby\KA vAiagy-rtuiv tiu.ti- CONTRACTOR LIC.#(REQUIRED): Ui C �o??5. t, CITY OF EVERETTYBUSINESS LIC.#(REQUIRED)Y PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR q OTHER(Please Specify) 41ç )IiC.01-1,k \ CONTACT NAME: CONTACT PHONE: 2c ') (0-65..... 19.1-0 < :. 56R. Vl(-tel(v�_t,� NA,1 V, CONTACT EMAIL: i ca t(-g11.�QXtJCi AeriA Y i.4,tomAh AGREEMENT.I hereby certify that ave qad and examined this application and know the same to be true an rrect. All pMVisions 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# � 41LCIA uli5DJ \q, E A-iStJ-OO Owner/Authod Ag t Signature Date (Revised 9/23/2016) .