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ELECTRICAL PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> (P)425-257-8810 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br /> PROJECT ADDRESS: 11311 19th Ave SE Everett, WA. 98208' Building C <br /> BUILDING AREA(if residential, new construction, remodel,or addition) SF <br /> BUILDING TYPE: ❑SFR-DETACHED ❑SFR-ATTACHED ❑DUPLEX ❑ MULTI-FAMILY-#OF UNITS: la COMMERCIAL <br /> i <br /> USE OF BUILDING: Apartments <br /> i <br /> ECjjj T t CAl bPOUdATION INFQRrIMA'1'1wOAI <br /> CONTRACT PRICE OF WORK: $ 480 -: <br /> r <br /> NUMBER OF DEVICES if low voltage): <br /> FIRE ALARM? ❑YES ® NO I; <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: Extend 20amp circuit and add outside light fixture <br /> CO�1tACT JNFORMA�"ON <br /> OWNER NAME: BlUwater Apartments TENANT NAME(If Commercial): Amber <br /> OWNER MAILING ADDRESS: STREET 11311 19th Ave SE <br /> �n Everett STATE WA z 98208 <br /> E <br /> OWNER PHONE: 425-357-8400 OWNER EMAIL: <br /> s <br /> F <br /> CONTRACTOR NAME: Active Engineering/Neighborhood Electric <br /> CONTRACTOR ADDRESS: STREET 6605 200th St SW <br /> ,,n Lynnwood STATE WA ziE 98036 <br /> CONTRACTOR PHONE: 425-776-8119 CONTRACTOR EMAIL: admindesk@activeengineering.net <br /> CONTRACTOR LIC.#(REQUIRF..D): AC71VE"088MS CITY OF EVERETT BUSINESS LIC.#(REQUIRED): 026248 <br /> PRIMARY CONTACT: 0 OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> E <br /> CONTACT NAME: CONTACT PHONE: 425-357-8400 /206-571-7965 <br /> i <br /> AMBER / LUCAS CONTACT EMAIL: <br /> t <br /> AGREEMENT.'1 hereby certify that 1 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 t am authorized by the owner of this property to perform the work for which application is made and t <br /> comply with the State Contractors Law 98.27 RCW and 236.200 WAC. <br /> k <br /> l <br /> I <br /> City of Everett Official Use Only <br /> It PERMIT# <br /> 03 <br /> Owner/Authorized Agent Signature Date (Revised 8/23/2096) <br /> I <br />