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eP14%,---4 ELECTRICAL PERMIT APP LIGATION <br /> CITY OFIVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-84!I0 I FAX 425-257-8857 I (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT ADDRESS:d i Oi s gist tact FI LLC4 <br /> BUILDING AREA(if residential, new construction, remodel, or addition) SF <br /> BUILDING TYPE: ❑ SFR-DETACHED 0 SFR-ATTACHED 0 DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: 5 <br /> ELECTRICAL APPLICATION INFORMATION <br /> CONTRACT PRICE OF WORK: $ 3/00 <br /> NUMBER OF DEVICES (if low voltage): <br /> FIRE ALARM? 0 YES p-tc6 <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: �rikttek TAM: /f-A 4 j few/4 <br /> Cr CONTACT7INFORMATION <br /> OWNER NAME: t J J /L41MJ (3 v4flj4GJ TENANT NAME(If Commercial): <br /> OWNERMAILINGADDRESS: STREET/` /10q2,3 1'O Sr- Ale y <br /> CITU L11` J f .l STATE 14.1+- ZIP re-)-V <br /> OWNER PHONE: t 35-9 S"©9-3 OWNER EMAIL: <br /> CONTRACTOR NAME: I. A..4 ) ( Y tS <br /> CONTRACTOR ADDRESS: STREET 3i a( f4,'(1��6.�` 4&/� �J! <br /> CITY El/filer ilex STATE �� ZIP VIM/ <br /> CONTRACTOR PHONE! �s lig 216/ CONTRACTOR EMAIL: b <br /> CONTRACTOR LIC.#(REQUIRED): Ert—A-lti fc1 v,�� CITY OF EVERETT BUSINESS LIC.#(REQUIRED):®f437 <br /> PRIMARY CONTACT: 0 OWNER 0 CONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: 'jL( ?/ 7- <br /> EVL -MOL CONTACT EMAIL: / E ( s <br /> 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 <br /> 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 <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 /> FEF <br /> PERMIT/7 #} <br /> E I \Z' D�G� <br /> Owne uthorized Agent Signature Datr� (Revised 10/12/2015) <br /> 9 9 <br />