1812 EVERETT AVE COLUMBIA BANK 2018-01-02 MF Import

ILECTRICAL PERMIT AI0LICATION CITY OF EVERETT PERMIT SERVICES c�5/ z -163 3200 CEDAR STREET, EVERETT, WA 98201 — LA (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits PROJECT SITE INFORMATION 0. PROJECT ADDRESS: 1—Of BUILDING AREA Of residential, new construction, remodel, or addition) SF BUILDING TYPE: ❑ SFR-DETACHED ❑ SFR-ATTACHED ❑ DUPLEX ❑ MULTI -FAMILY - ft OF UNITS COMMERCIAL USE OF BUILDING: k ELECTRICAL APPLICATION INFORMATION CONTRACT PRICE OF WORK: E 2�) NUMBER OF DEVICES if low voltage): FIRE ALARM? ❑ YES ((NO ASSOCIATED BUILDING PERMIT # (if applicable): DESCRIPTION OF WORK: 2, ('Ak `1 his /V Q�/UL 71TrCC CONTACT INFORMATION OWNER NAME: ) T /(� �\ I TENANT NAME Qf Commercial : U, i Yy,n OWNER MAILING ADDRESS: sMEET ,;L CITY STATE 7P L r� OWNER PHONE: D OWNER EMAIL: CONTRACTOR NAME: CONTRACTOR ADDRESS: STUEFT I Sf i CITv ,{f^/-' �� t/`.n �J. //� STA,L GVA 2- CONTRACTOR PW)N L 13 - 7 17 CONTRACTOR EMAIL: a . t7 1 ffo• r . CONTRACTOR LIC. eIR[ODIREDC O pp '•IM CITY OF EVERETT BUSINESS LIC. 1111tRE0t11REDI' Q PRIMARY CONTACT: ❑ OWNER CONTRACTOR ❑ OTHER (Please Specify) CONTACT NAME: CONTACT PHONE: ZS ) 2-2 S - 7J 7 CONTACT EMAIL: AGREEMENT T hereby candy that1have mad and examined this application and know the same lobe (me and coRUcf All provisions of laws and ordinances govommq this type of work will be complotad whether specified herein drool The granting of a permit does not presume to give authonty to violate or canool the provisions of any clhor state or local law regulating constmchon or the performance of construction. That I am aulhonzed by the owner of this property to perform the work for which epplicahon is made and C. comply with the State Contractors Law 18 27 RCW one 296 200 WAC Agent Signature City of Everett Official Use Only FEE PERMIT # Date (Revised 1011212015)